Endocrine Abstracts

Background: People with diabetes account for 15–20% of total inpatients in Scottish hospitals. Provision of specialised diabetes care is integral in minimising length of stay and diabetes-related complications in such patients. Consequently, inpatient diabetes teams have been implemented throughout the UK as recommended by the Joint British Diabetes Societies.

Methods: The amalgamation of several Glasgow hospitals into a single large teaching hospital, the Queen Elizabeth University Hospital, permitted the establishment of a new inpatient diabetes service and the integration of electronic diabetes inpatient referrals. We conducted an analysis of electronic diabetes inpatient referrals made via the Trakcare patient management system in October 2017 (n=143), which replaced an email-based system. We assessed patient diabetes subtype, referral reason and location. Lastly, we analysed the total number of referrals made (n=2034) in the 1-year period following the introduction of this referral process (May 2017–May 2018).

Results: The majority of referrals were made for people with type 2 diabetes (58.7%), compared to type 1 diabetes (36.8%) and ‘steroid induced diabetes’ (4.9%). The most common reason for referral was hyperglycaemia (27%), followed by patient education (15%), diabetic ketoacidosis (12%) and hypoglycaemia (11%). Referral issues were resolved within the same day in 59.1% of cases, however, 20.8% of patients were referred more than once per month. 40% of referrals were made from general medical wards, 10% arose from admission units and 7% from critical care. After 1 year the number of referrals per month increased from 105 to 194, compared to ~50 referrals per month observed when emails were utilised.

Conclusion: Engagement with the integrated electronic diabetes inpatient referral system has been excellent. The significant increase in referrals demonstrates the previously unmet need for specialist inpatient diabetes input and care, and highlights the impact of electronic referral systems upon local diabetes service provision.