Endocrine Abstracts

Introduction: We undertook a review of all known paediatric diabetic admissions in the Belfast Trust during a two year period between February 2023 and January 2025. We reviewed number of admissions, reason for admission, age, length of stay, HbA1c and need for Paediatric Intensive Care. We wanted to ascertain the proportion of known diabetics that were admitted, how many were admitted with diabetic ketoacidosis (DKA) and what demand this had on our workforce.

Methodology: A previous list of patients collected by our Paediatric Diabetic Specialist Nurses was used. Missing data was identified and collected using electronic records and paper notes. Using these methods we were able to acquire majority of all the data we needed.

Results: Over a two year period we found 35 admissions for 18 different patients. 6 patients were admitted multiple times, 4 of which were over 12 yrs of age. One patient was admitted a total of 7 times over a 2 year period. 51% of admissions were due to DKA. Our longest stay was 82 days for investigation of Subcutaneous Insulin Resistance Syndrome. The median length of stay was 2 days. Of those admitted with DKA, only 28% required Paediatric Intensive Care. Mean length of stay for DKA was 2.7 days, range 1 – 10 days. The majority of our DKA admissions were over 12 yrs of age and had a higher HbA1c compared other admissions. Admission rate for our known diabetics is 17.5 per year. Our workforce calculations showed that 9% of our current case load of patients were admitted per year which equated to 42.5 hours of our workforce time per year.

Conclusion: 9% of our current caseload per year of known paediatric diabetic patients get admitted. Half of admissions are due to DKA, majority are over 12years old and have high HbA1c. We use a traffic light system for a management of high HbA1c and recently started over 12 years diabetic pump clinic. We are considering further age banded and high Hba1c clinics to reduce rate of DKA admission and work force time.