Endocrine Abstracts

Aim: Type I Diabetes Mellitus is a chronic metabolic disorder with an incidence of 24,000 children in the UK. NICE has recommended the use of the sensor augmented pump (SAP) in managing short and long term diabetes related complications. Limited literature is available in the paediatric population. SAP is designed to allow continuous glucose monitoring, with real-time adjustment of insulin; making it superior to other pump systems. 0.8% of children suffer from Type I DM in the Wigan Borough. SAP was introduced in these children as a trial; who were previously on insulin pumps with limited success in managing hypoglycaemic episodes. The aim of the audit was to identify how effective SAP was in reducing HBA1c and preventing hypoglycaemic episodes.

Method: 14 children were commenced on the SAP between 2016–17 March. Evidence was collected from electronic records, which, summarized clinic letters from the consultant and diabetic nurse team. Date of diagnosis and initiation of SAP following that was dictated. The number of hypoglycaemic episodes causing admission to hospital and HBA1c was compared before and after the SAP was started.

Results: There were equal number of males and females. The average age of Type I DM diagnosis was 6 years 2 months. The average age when SAP was commenced was 8 years 1 month. Average HBA1c prior to SAP was 63.1 and showed 5.3% improvement following SAP with 59.8. 64.3% showed improvement, whereas, 21.4% of children showed deterioration in HBA1c. These were males and belonged to an older age group (>5 years). 14.3% of children did not show any change in their HBA1c. 29% of children had severe hypoglycaemic episodes prior to SAP. Following SAP, 7.1% of children had a severe hypoglycaemic episode.

Conclusion: NICE 2016 has recommended the use of SAP in improving the quality of life for people with Type I DM. The audit highlighted improvement in glucose control with positive effect on HBA1c and reduction in hypoglycaemic episodes. This can be explained with increased adherence to treatment with the use of automatic insulin monitoring and delivery. Ultimately, SAP offers benefit to the NHS with cost and resource saving.