Endocrine Abstracts

Background: Within the NHS Greater Glasgow and Clyde (GGC), many children with type 1 diabetes mellitus (T1DM) are looked after at the RHSC until the age of 16 years, after which they are transferred to their local adult diabetes services. This is the first longitudinal audit within the GGC looking at the changes in diabetic control of the patient pre-and post-transfer.

Method: A cohort of 75 patients referred onto the adult diabetes service from RHSC in 2008 was identified, of which 58 patients were eligible for inclusion in the audit. Glycaemic control, assessed by HbA1c and complication data at the time of transfer (2008) were collected from the Magistral database, and compared with the latest (2013) results available from the SCI-Diabetes database. Parameters of interest included HbA1c, retinopathy, microalbuminuria, and neuropathy.

Results: The average HbA1c value changed from 73 mmol/mol in 2008 to 86 mmol/mol (P<0.001; paired sample tests). Patients in the extremely high risk category (of developing complications) increased from 23 (39.7%) to 37 (63%). Background diabetic retinopathy rose from 4 (6.9%) to 19 (32.8%) patients, of which 5 (8.6%) now have maculopathy. The number of people with microalbuminuria also increased from 0 to 8 (13.8%). 4 (6.9%) patients are currently at increased risk foot ulceration due to impaired sensory nerve function or absent pulses. The average attendance rate also dropped from 3.6 to 2.3 visits/18 months (P<0.001; paired sample tests).

Conclusion: Patient’s glycaemic control appears to deteriorate in the 2008 cohort 5 years on from transfer to the adult services with significant increase in microvascular complications.