Endocrine Abstracts

Background: The inclusion of a youth worker within a transition service can be pivotal to its success.

Objective: To assess the impact of a youth worker on diabetes care in adolescents with type 1 diabetes (T1DM) over a 6 month period by measuring HbA1c levels (primary outcome), Personal Development Tool score (PDT), hospital admissions and clinic attendance (secondary outcomes).

Method: Prospective cohort study. 20 adolescents (age 14–18 years;10 males) with T1DM >1 year. Subjects divided into 2 equal groups depending on HbA1c value; Group 1 HbA1c ≥75 mmol/mol and Group 2 HbA1c 58–74 mmol/mol. Intervention: Youth worker input for 6 months with completion of PDT, which assesses 8 areas of diabetes care (marked out of 5, with a total score of 40) by the adolescent at the start and finish.

Results: [Mean(SD)]. Age at recruitment for group 1 was 17.2(1.3) years and group 2 was 15.8(1.6) years, and duration of diabetes (9.6 and 9 years respectively). HbA1c at recruitment was 109(20.2) mmol/mol in group 1, and 97.4(21.2) mmol/mol after 6 months. In group 2 HbA1c at recruitment was 63.2(3.7) mmol/mol and 69.5(9.3) mmol/mol after 6 months.

In groups 1 and 2, average PDT score improved after 6 months from 21 to 28 and from 29 to 34 respectively. Average number of hospital admissions (2.6) and clinic non-attendance (3.5) was higher in group 1 compared to group 2 (0.5 and 2.8 respectively). Time in hours spent with the youth worker during the 6 months in group 1 (26.2) and group 2 (28) was comparable. However, more time was spent individually (7.4 hours) than in group time (18.8 hours) with patients in group 1 compared to group 2 (2.7 hours individually, 25 hours of group time). Female patients spent less time with the male youth worker.

Conclusions: The youth worker had a positive effect on the diabetes control as demonstrated by reduced average HbA1c values in group 1 and higher PDT scores in both groups after 6 months. The addition of a female youth worker may provide better continuity and diabetes care as self-esteem, coping styles, peer-pressure and identity all have gender elements.