Endocrine Abstracts

Introduction: In the Cardiff and Vale (C&V) Health Board, there are 203 children and young people (CYP) under the care of the multidisciplinary team (MDT), 96% of whom have T1DM. Every CYP is offered four outpatient clinic appointments every year, one of which is an annual review. The majority of them are situated in the University Hospital Wales (UHW) site, whereas the University Hospital Llandough (UHL) clinic was introduced in 2016 for easier access for the CYP from the...

Introduction: Diabetic Ketoacidosis (DKA) is a life threatening complication of type 1 diabetes mellitus (T1DM) in children. An integrated care pathway (ICP) for management of DKA based on guidelines published by the British Society for Paediatric Endocrinology and Diabetes has been established in Wales with the 2nd edition published in May 2010.Aims: To audit the management of DKA in a teaching hospital following the introduction of the second edition o...

Introduction: Diabetic Ketoacidosis (DKA) is a potentially life threatening complication of type-1 diabetes mellitus (T1DM) in children and young people (CYP). An Integrated Care Pathway (ICP) for management of DKA is based on the current British Society for Paediatric Endocrinology and Diabetes (BSPED) guidelines. The BSPED guideline moved away from cautious fluid replacement toward a liberal approach for resuscitation and maintenance fluids based on current evidence. The ICP...

Introduction: The pandemic resulted in changes in delivery of healthcare. Most children and young people (CYP) present with symptoms of T1D for the first time to primary care. Delayed diagnosis is common and associated with risk of life-threatening diabetic ketoacidosis (DKA). In Cardiff, we had a pre-pandemic QI project to improve early diagnosis of T1D. We escalated responses, introduced initiatives to facilitate early diagnosis.Aim: To develop effecti...

Background: HbA1c is an important indicator of long-term glycaemic control in CYP with established diabetes mellitus (DM). The WHO recommends that diagnosis of DM requires measurement of blood glucose, and that HbA1c is not validated as a diagnostic test in CYP. NICE guidance recommends any child with suspected Type 1 DM should have a POC BG test and same day referral to secondary care. Requesting HbA1c in primary care may delay diagnosis of Type 1 DM, leading to potentially l...

Introduction: Type 1 diabetes (T1D) is a lifelong condition affecting over 29 000 children in the United Kingdom, the majority of whom are in full time education. Both hypoglycaemia and hyperglycaemia have been shown to impact the young person’s overall school performance and learning capacity. During exams, children and young people (CYP) with T1D have the additional stress of managing their diabetes appropriately, and therefore require special provisions. Currently, the...

Introduction: Diabetic Ketoacidosis (DKA) is a life-threatening complication of Type-1 diabetes mellitus (T1DM) in children and young people (CYP). An Integrated Care Pathway (ICP) for management of DKA is established in Wales with the 3rd edition published in March 2016. This is based on the 2015 British Society for Paediatric Endocrinology and Diabetes (BSPED) guidelines.Aims: To audit the management of DKA in a teaching hospital following the introduc...

Introduction: Diabetic Ketoacidosis (DKA) is a potentially life-threatening complication of type 1 diabetes mellitus (T1DM) in children and young people (CYP). A 5th edition Integrated Care Pathway (ICP) for the management of DKA was published in 2022 in Wales based on updated guidance from BSPED, NICE, and the UK resuscitation council.Objective: To audit the management of DKA in CYP at Noah’s Ark Children’s Hospital for Wales following the int...

Introduction: There were concerns voiced by health care professionals (HCPs) that restrictions to healthcare delivery during the pandemic has resulted in delays in diagnosing T1D in CYP. Most CYP present with symptoms of T1D to primary care. Delay in diagnosis increases the risk of potentially life-threatening diabetic ketoacidosis (DKA). In Cardiff, we piloted QI initiatives pre-pandemic to improve early diagnosis which was introduced across the Children and Young People&#146...

Introduction: Most children & young people (CYP) with symptoms of type 1 diabetes (T1D) tend to present to primary care. Delayed diagnosis is common and is associated with a risk of developing diabetic ketoacidosis (DKA). The prevalence of DKA at diagnosis over the last 20 years remains unchanged despite current NICE guidance and Diabetes Delivery Plans which promote prompt diagnosis of T1D. The aim of this QI initiative was to develop effective pathways to facilitate earl...