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Endocrine Abstracts (2015) 39 OC8.3 | DOI: 10.1530/endoabs.39.OC8.3

BSPED2015 ORAL COMMUNICATIONS Oral Communications 8 (5 abstracts)

Frequent patient contact to improve HbA1C- face-to-face or ‘Virtual’?

Ambika Karthikeyan , Heather Stirling & Paediatric Diabetes Team


University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.


Background: National Paediatric Diabetes Audit report 2012–2013 showed an increase in the number of patients with HbA1C >80 mmol/l at our paediatric diabetes unit.

Aim: Two methods of intensive support for patients with high HbA1C were trialled- monthly clinics and weekly telephone contact.

Method: From January to June 2014 we offered monthly ‘Target’ clinic appointments to a cohort of ten patients with high HbA1C. Consent was obtained prior to attending this clinic. Group education sessions were offered as part of the clinic and individualised targets were set at each consultation. The ‘Virtual’ weekly telephone clinics were run from January to June 2015. Patients with the highest HbA1Cs from our entire clinic population were included. At each contact blood glucose was reviewed, insulin doses were adjusted and targets for the next week were set.

Results: Six out of ten patients in the Target clinic were girls. Median age was 10.4 years (range 9.4–13.7). Median duration of diabetes was 4.1 years (1.5–9.5). Median HbA1C at first appointment was 88 mmol/mol (74–109), after 6 months it was 82 mmol/mol (67–101). 18 patients were contacted in the weekly Virtual clinic. Median age was 15.6 years (11.1-18), 11 were male. Median duration of diagnosis was 6.8 years (1.1–13.6). Median HbA1C at the start was 93 mmol/mol (71–>130), after 6 months it was 75 mmol/mol (56–123). 33.4% of appointments in the Target clinic were missed compared to 46.5% in the Virtual clinic.

Discussion: Patients in the Virtual clinic were older, with longer duration of diabetes and higher HbA1C at the outset. This was however an ‘unbiased’ cohort because consent was not sought for participation in this clinic, telephone contact was made as part of normal clinical care. Despite these differences a bigger improvement in HbA1C was achieved through the Virtual clinic. Higher non-attendance rate in this clinic was anticipated as contact was more frequent and patients were likely to attach less importance to a Virtual clinic.

Conclusion: More frequent patient contact leads to improved glycaemic control. Telephone clinics are an effective and efficient method of delivering the sustained support required by patients with poor glycaemic control.

Volume 39

43rd Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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