Endocrine Abstracts

Purpose: It is well-known that adolescence is a time when glycaemic management can worsen and transitioning into adult services can compound the issue. There is currently no approved standardised transition model making practise across different hospitals variable. Our aim was to review the differences in management and outcomes of patients with T1DM aged 16-19yrs between those cared for by the paediatric and the young adult service at GSTT. Patients in this age group are vulnerable, some hospital trusts insist that patients >16 years of age are admitted onto adult wards. GSTT is one such trust and whilst there is some crossover between paediatric and adult diabetes teams the staffing ratios and care pathways are significantly different.

Methods: Data for patients with T1DM (aged 16-19 years) for the 2024-25 NPDA submission was collected by the paediatric and adult teams for patients under their care. The data from each service was collated separately prior to combining the data for NPDA submission. Outcomes for each service were reviewed and compared.

Results: The data showed suboptimal care and glycaemic levels in both groups. 53 patients were included (18 under paediatrics services and 35 under young adult service). The table below shows differences between care processes and outcomes for these patients:

Conclusion: The paediatric diabetes team have a higher staff to patient ratio including a dedicated allocated key worker for each patient facilitating additional contacts between clinic visits. The results amplify the importance of establishing a standardised transition process for the completion of care processes and patient pathways. There is a clear need for joint working between paediatric and adult teams to enable improved outcomes for these patients across the board.