Endocrine Abstracts

This audit aimed to evaluate adherence to key standards of care for Type 1 Diabetes Mellitus (T1DM) based on the Irish National Clinical Guidelines, published in May 2024. Data from patients with T1DM attending St James’s Hospital diabetes clinic and being treated with multiple daily injections of insulin were included. Data was collected on parameters including clinic appointments, use of continuous glucose monitoring (CGM), most recent HbA1c, 14-day time in range (TIR), attendance at structured education, whether hybrid closed loop (HCL) insulin pump therapy had been offered, and use of carbohydrate counting (CC). Data from 488 patients was collected. Of these, 99% were offered at least two diabetes appointments annually. 93% of patients were offered CGM and 78% were using a CGM device. Enrolment to DAFNE (Dose Adjustment for Normal Eating), either virtual or in-person, was offered to 59%, with 31% of those completing the course. Patient’s median HbA1c was 64 (56-74) mmol/mol. Only 10% of patients achieved a HbA1c ≤48 mmol/mol and 20% had HbA1c≤53 mmol/mol. Median TIR was 47% (31-64%). Dietitian input was offered to 99% of patients, CC education to 82%, and 55% of patients were actively CC. HCL insulin pump therapy was offered to 48%, with 22% of those successfully transitioning to pump therapy. National guidelines provide a robust framework for delivering high-quality diabetes care. This audit highlights adherence to many aspects of these guidelines, however gaps remain in achieving glycaemic target, and the uptake of structured education programs, and increasing access to insulin pump therapy.