Endocrine Abstracts

Introduction: As per the American Diabetes Association guidelines published in March 2022, ACR should be measured in all patients with type 1 diabetes with duration of ≥5 years and in all patients with type 2 diabetes regardless of treatment. In patients with diabetes with deranged RFTs or reduced EGFR, ACR should be checked twice per year.

Aim: we sought to identify the standard of care delivered in our secondary care centre against the recommendations of American diabetes association.

Methods and Results: Between December 2023 and January 2024, 42 patients attended our diabetes outpatient services including type 2 DM 36(85.7%). Mean HbA1c was 59.11±15.8 mmol/mol. 22 (52.3%) patients were on ACE or ARBs and 14 (33.3%) were on SGLT-2 inhibitors. 23 (54.76%) of the patients had ACR taken in last year. 11 (26.1%) had either abnormal ACR or reduced EGFR, of which 3 (27.2%) had ACR samples taken twice per year.

A Re-Audit: Was conducted in May 2024 to July 2024, post education of doctors as well as engagement with phlebotomy services to improve the collection of ACR samples. 48 patients including 36(75%) with type 2 DM. Mean HbA1c was 62.7±17.7. 36(75%) were on ACE or ARBs with 19(39.5%) on SGLT-2 inhibitors. 39(81.3%) had their ACR taken over last year. 16(33.3%) patients had either abnormal ACR ≥3.3 g/mol or reduced EGFR ≤ 60 mL/min/1.73, of which 8(50%) had their ACR taken twice per year.

Conclusion: We have demonstrated the improvement in measurement of ACR in our patients with the help of education and engagement with our phlebotomy services.