Objectives: In the UK the majority of young people presenting for the first time with signs and symptoms of type 1 diabetes (T1D) are initially seen by general practitioners (GPs). Mis- or delayed diagnosis is not uncommon, and it increases the risk of diabetic ketoacidosis-related morbidity. This study seeks to identify the specific challenges faced by GPs in this setting in order to develop effective care pathways and recommendations for improving the timely diagnosis of T1D.
Methods: An online survey questionnaire was distributed to all GPs in Cambridgeshire and Peterborough CCG. Questions asked included: demographic information; clinical knowledge on diagnosis of child T1D; referral pathways; equipment access; and training experiences.
Results: 551 GPs were directly approached. 63 responded (11.4%) and were representative of GPs in England in terms of prior experience. 38 (63%) responders had diagnosed T1D in a child before. Once T1D was suspected, 87 and 100% would perform urinalysis and a finger-prick blood test respectively on the day of presentation. However, 38, 19, and 27% also chose to test for venous blood glucose, fasting blood glucose and HbA1C respectively to confirm their diagnosis. All responders would arrange urgent (same day) referral to hospital or call the local childrens diabetes team for advice. All respondents had access to a standard glucometer, but 23% used it less than once a year. 43% described their previous T1D training as barely adequate or inadequate, and the majority (82%) indicated that further training was required.
Conclusions: Our study provides evidence that more training/education on child T1D in primary care is needed. Whilst there was appropriate use of urinalysis and finger prick blood testing, education targeted at raising the awareness for T1D and avoiding unnecessary tests that may result in delay in diagnosis, are required.
23 - 25 Nov 2016
British Society for Paediatric Endocrinology and Diabetes