Endocrine Abstracts

Introduction: NICE Guidance 18 updated in March 2022 will make real-time continuous glucose monitoring (rtCGM) the standard of care and recommends the cheapest rtCGM that meets an individual’s needs. Eight rt-CGM devices have Conformité Européene (CE) mark for paediatrics with type 1 diabetes. There are no published performance standards for CE mark; however, the Food & Drug Administration (FDA) published their interoperable CGM (iCGM) criterion. For iCGM ap...

This talk starts by focussing on how to set insulin to carbohydrate ratio and duration of insulin action and then how to test if they are set correctly. The talk then progresses into showing the mismatch between carbohydrate absorption and insulin action and how to use practical tips and pump tricks to reduce post-prandial glycaemia. The talk finishes with suggestions of when to use different bolus options such as dual wave (split) and extended (square)....

Introduction: The COVID-19 pandemic prevented face-to-face school diabetes training in 2020/2021 at Birmingham Women’s and Children’s Hospital. Moving school training online was the only viable option to ensure children with type 1 diabetes could attend school.Objectives: 1. Develop an online school training package with competency assessment for all diabetes devices 2. Audit the number of staff competent and the cost and acceptability of the t...

Introduction: Ongoing structured education for children and young people with type 1 diabetes and their families is considered essential by ISPAD (2014) and NICE (2015), because there is a lot of education and skills that need to be reinforced.In 2016 the majority of the self-management education was provided at our trust by diabetes self-management education (DSME) sessions, which are two hour sessions designed to improve self-management. This format of...

Successful management of diabetes requires an empowered patient/family that is well-educated about their condition and feels confident to self-manage with the support of their medical team. The linchpin to assessment and effective change is the quality of available information. Most patients/families have no way of pulling all their diabetes information together efficiently, and consequently often feel helpless and do not take charge of making their therapy adjustments. Diasen...

Objectives: The Diabetes Team at Birmingham Children’s Hospital modified the advanced bolus algorithm suggested by Bell (2015), to develop the KISS (Keep it Simple and Safe). KISS involves adding 25% extra insulin to meals identified as very high fat and protein, and spreading the insulin by a split bolus, 50% now and 50% over 2.5 hours. KISS also has an adjustment tool allowing extra insulin to be added and the split modified from monitoring. KISS is intended to be a sim...

Introduction: The International Society for Paediatric and Adolescent Diabetes (ISPAD) 2022 Nutritional Guidelines recommend calculating carbohydrate requirements using an indivualised equation, such as the Schofield equation. Up to 2023, our centre used the Scientific Advisory Committee on Nutrition (SACN) 2011 guidelines that only require age to determine average carbohydrate requirements. The latest National Paediatric Diabetes Audit (NPDA) showed our centr...

Introduction: Achieving glycaemic targets for young children with type 1 diabetes (T1D) is challenging due to rapidly changing physiology and behavioural patterns. An under-fives specialised multidisciplinary clinic (U5-MDT) was implemented in January 2022 due to poorer glycaemic control in this group compared to the rest of the clinic cohort. The U5-MDT aimed to optimise glycaemic control through access to technology while providing family support.<p clas...

Background: Children and young people (CYPwD) with a persistent high HbA1c are at greater risk of developmental and long-term complications. Diabetes services across the England & Wales are mandated to have a ‘high HbA1c’ policy by the Best Practice Tariff quality standards, to improve health outcomes. Aim: To evaluate the Birmingham Women’s and Children’s (BWC) Diabetes Team ‘High HbA1c Policy’ from 2016 – 2019.</p...

Background: In 2019, funding for continuous glucose monitoring (CGM) commenced for children and young people with diabetes (CYPD) in our region. However, there was no local established CGM structured education programme. We developed ‘the CGM Academy’ with continuous improvement using the Plan-Do-Study-Act (PDSA) cycle.Objectives: To review the PDSA cycle of improvements to deliver structured education using CGM.Methods: ...