Endocrine Abstracts

The specialist weight management service (SWMS) is a tier 3 service offered to patients who meet a criterion of raised BMI with or without comorbidities. It is a multi-disciplinary service made up of physician, GPwSI, dietitians, physiotherapist, psychologists and health trainers. Approximately 40% of the patient within the service has type 2 diabetes. As part of a quality improvement pilot study a diabetes specialist nurse was introduced to the team. Patients were seen in an initial MDT with the diabetes nurse present. Changes to medication would be made at this MDT and followed up after 2–4 weeks by the nurse. Regular appointments with the nurse were arranged after this on an individualised basis. Over a period of 10 months the diabetes specialist nurse saw 133 patients. 65 were female and 68 were male. The age range was 22–74 years (mean age 52.9 years). Their starting HbA1c was measured as part of the referral to SWMS this was then repeated after 4 and 8 months within the service. 24% of the data is missing due to patients been in the service less than 4 months or leaving the service. Of the available data 89% of patients maintained or improved their HbA1c. 58% of patients improved by at least 5 mmol. 45% improved by at least 10 mmols. 23% improved by at least 20 mmol and 9% improved by at least 30 mmols. Three patients were identified as making significant improvements. Patient 27 lost 10.4 kg in weight in 4 months and reduced their HbA1c by 76 mmol. Patient 67 lost 15.8 kg in weight in the 10 months and reduced their HbA1c by 59 mmols and patient 126 lost 8.2 kg in weight in 4 months and reduced their HbA1c by 55.