Endocrine Abstracts

Introduction: Patients who have diabetes are at risk of complications, both acutely and in the long term. Although care is individualised, it may not be practical to continuously review this on an individual basis. An audit evaluating outcomes is a useful tool to reflect on multidisciplinary team management. We describe how effective use of resources led to better results in a multi-ethnic population.

Population: A total of 130 children and young people who received care at North Middlesex Hospital(NMH) were included.

Methodology: The Paediatric Diabetes Unit at NMH has been participating in the National Paediatric Diabetes Audit (NPDA) since 2010. Data currently submitted is based on routine care, screening, outcomes and admissions. Data collated from electronic recording systems is submitted to the Royal College of Paediatrics and Child Health(RCPCH). Once centrally analysed, reports are released to participating units and also published in public domain.

Results: Of the 130 children, 62% were above 10 years of age. The population was multiethnic and included 28.5% white, 23% black ad 5% Asian. Nearly 18% were on insulin pumps. Over 90% had Type 1 Diabetes Mellitus and 7% Type 2. There was sustained and remarkable improvement in median HbA1c levels over the past years, dropping from 74 mmol/mol in 2013/14 to 63 mmol/mol in 2015/16, thus dropping below the average for London (65.5 mmol/mol) and England (65 mmol/mol).

Conclusion: The remarkable improvement in glycaemic control was achieved through provision of adequate resources such as recruitment of staff to facilitate initiation of insulin pump therapy, providing more intensive support and teaching carbohydrate counting from diagnosis. This was boosted by team commitment and cohesiveness leading to improved patient engagement. The achievement is commendable given the patients’ diverse cultural and ethnic backgrounds, which are more marked compared to some other boroughs in London and outside.