Endocrine Abstracts

Objectives: Many paediatric diabetes units in the UK have introduced 24 h telephone support to encourage self-management to reduce Emergency Department (ED) attendances and admissions. The UK national audit collects information on acute paediatric diabetic admissions; but there is no data available on ED attendances in this group. We undertook a retrospective audit of ED attendances as part of a baseline service evaluation of our newly introduced 24 h support service.

Methods: The details and outcomes of local ED attendances of children with type 1 diabetes (n=177) registered under the care of a large inner-city Paediatric Diabetes Unit between September 2011 and August 2014, were retrospectively reviewed with an electronic database.

Results: A mean of 39 children with T1DM (23% of those registered in clinic) attended the ED annually. The total number of episodes over the 3 years was 167. 72% were due to a ’diabetic’ complaint. 30.3% of these accounted for their first diagnosis of T1DM. In those with an established diagnosis, 63/84 (73.8%) of attendances were due to hyperglycaemia, including DKA. 14.2% had hypoglycaemia and 12.2% had ‘troubleshooting’ queries. Importantly, 43/84 (51%) of cases had a concurrent illness, such as gastroenteritis, with their diabetic issue. 49/84 (56.3%) of cases were admitted, with a mean duration of 3.4 days. No trends were seen over the 3 years in any of the variables. Only 11.5% of these diabetes-related episodes were documented to have accessed the helpline.

Conclusion: Up to 23% of the cohort attended an ED. The vast majority of cases were related to glycaemic control. Only half had a concurrent illness. Half of the attendances were discharged back to the community. These could possibly have been avoided by early clinical advice. A targeted 24 h helpline could prevent them from presenting to ED, encouraging better self-management and glycaemic control.