SFEBES2023 Poster Presentations Metabolism, Obesity and Diabetes (70 abstracts)
HbA1c assessment and inpatient diabetes management for people diabetes and moderate/severe frailty: audit results from a UK teaching hospital
Eka Melson 1,2 , Mohamed Fazil 1 , Hnin Lwin 1 , Kevin Thottungal 1 , Carmen Chan 3 , Anu Thomas 1 , Faseeha Aftab 1 , HayMar Tun 1 , Sadaf Saeed 1 , Meri Davitadze 1 , Alison Gallagher 1 & Kath Higgins 1
1University Hospitals of Leicester, Leicester, United Kingdom. 2University of Leicester, Leicester, United Kingdom. 3NHS Tayside, Dundee, United Kingdom
Introduction: Inpatient admission presents an opportunity to deintensify treatment in people with diabetes and frailty. The Joint British Diabetes Society recommends checking HbA1c in people with diabetes and frailty during admission if it had not been checked in the preceding six months. The audit aimed to identify the proportion of people who had their HbA1c checked upon admission and, if appropriate, what proportion had their treatment deintensified.
Methods: We retrospectively collected data on people with diabetes and clinical frailty score (CFS)≥6 discharged from the medical unit in 2022. HbA1c data prior to and during admission were collected. Deintensification was defined as any reduction in blood glucose lowering medication or switching of medications to those with less risk for hypoglycaemia. Descriptive statistics were performed.
Results: Four-hundred and thirty-six patients were included in our analysis [Age: 79.5 years (IQR=71-86). 52.1% (n=227/436) were women and the median CFS was 6 (IQR=6-7). 29.4% (n=128/436) of the admissions were due to falls. 35.6%(n=155/436) of patients admitted to the hospital did not have their HbA1c assessed in the preceding six months. Of these, only 9.0% (n=14/155) had it checked during this admission. In patients with HbA1c <7.0%, only 10.6% (n=22/207) were deintensified during admission.
Conclusion: Despite National recommendations, only a small proportion of patients had their HbA1c assessed during inpatient care, when appropriate, and there were low rates of treatment deintensification. Quality improvement programs are warranted to improve inpatient care for people with diabetes and moderate/severe frailty which includes assessment of HbA1c which in turn will guide decision-making regarding further deintensification.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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