Endocrine Abstracts

Introduction: Poor HbA1c in the first year following diagnosis of type 1 diabetes is a predictor of poor metabolic control and early development of complications. Achieving good glycaemic control requires compliant, well-educated patients. In October 2013, we introduced a revised and extended ‘Newly Diagnosed Patient Education Programme’ in which a total of 20 sessions are delivered by the multidisciplinary team.

Aim: To assess the effect of the new policy for newly diagnosed type 1 diabetics on their HbA1c in the first year.

Method: All type 1 diabetics diagnosed October 2013 to October 2014, who completed the new education programme were analysed and compared to a pre-intervention group diagnosed January to December 2010. Data obtained included HbA1c during the first year post diagnosis, patient demographics and psychosocial factors.

Results: patients (eight males, 16 females) were included in the study group compared to 17 (six males, 11 females) in the pre-intervention group. HbA1c at diagnosis was 11.4% for the study group compared to 10.2% in the pre-intervention group. Whilst at 6–8 weeks similar HbA1c levels were achieved (8.1% vs 8.0%), HbA1c at 12 months measured 8.1% vs 7.6%, but a similar percentage of patients in both groups achieved an Hba1c < 7.5% (55% vs 53%).

Discussion: Psychosocial factors varied greatly between groups, with the study group having higher numbers of social risk factors (CAF 2 vs 0, split families 9 vs 3, domestic violence 3 vs 0, ongoing psychology support 8 vs 2, clinical depression 2 vs 0), impacting on diabetes management. It is encouraging that despite this, the percentage of patients achieving HbA1c levels < 7.5% one year after diagnosis is similar between groups.

Conclusion: Current data highlights that the service is providing care to a socially challenging population and will need further consideration and tailoring. Long-term outcomes are awaited.