ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 66 P25 | DOI: 10.1530/endoabs.66.P25

Modifiable dietary factors and a case for tracking dietetic outcomes in the National Paediatric Diabetes Audit

Lucia Martinez de la Escalera

University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

Children and young people (CYP) with Type 1 Diabetes who maintain a healthy BMI, diet and accurate carbohydrate-counting have lower risk of cardiovascular disease and diabetes complications. The tracking of key Diabetes health checks and outcomes via the National Paediatric Diabetes Audit (NPDA) has been successful in ensuring year-on-year improvement of national average HbA1c. Aside from BMI however, Dietetic-specific outcomes are not currently included in the NPDA. Therefore, the present audit designed and trialled 5 Dietetic outcome measures which can be used to track adherence to dietary management goals (as per 2015 NICE guidelines for Paediatric Type 1 Diabetes) year on year. These outcomes are: 1) Daily serves of fruit, 2) Daily serves of vegetables, 3) Daily serves of ultra-processed and discretionary foods, 4) meeting Calcium requirements, 5) main carbohydrate-counting method used. Baseline data for these outcomes were collected through a standard Dietitian-led questionnaire at each patient’s annual Dietetic review during the last full financial year (April 2018–March 2019). Latest HbA1c and BMI centile at the time of the Dietetic review were also collected. The cohort comprised 107 patients with type 1 diabetes, aged 2–18 years who attended their Dietetic annual review at a UK-based Paediatric Diabetes unit. Gathering of baseline Dietetic outcomes for the whole patient cohort provided key insights into Dietary trends and problem areas. Only 6% of CYP meet minimum recommendations for daily vegetable intake (3 serves), whilst 46% meet daily fruit recommendations (2 serves). Ultra-processed foods appear to replace daily vegetables for the majority of CYP, with 75% of cohort significantly exceeding recommended limits (0–1 serves per day). Indeed, 50% of CYP interviewed reported 3 or more ultra-processed foods per day. Calcium requirements were met by just over half (55%) of children. Finally, CYP who reported using weighing scales regularly displayed significantly lower average HbA1c (60 mmol/mol) compared to those who relied on pictorial tools (71 mmol/mol) or guessing (78 mmol/mol). In conclusion, Dietetic outcomes are valuable monitoring tools which highlight specific problem areas in need of addressing, and inclusion in the NPDA.

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