Endocrine Abstracts

Introduction: Hypoglycaemic episodes (Hypos) can happen at any time in type 1 diabetes patients; sometimes quite unpredictably. Carrying ‘hypo supplies’ at all times is basic to good diabetes care; often delegated to parents for children with diabetes. The primary aim was to assess how this basic care activity is practised in real life; secondary aim was to correlate lack of hypo supplies with diabetes control or other patient characteristics.

Methodology: The prospective audit was conducted over 2 weeks, where all patients attending any paediatric diabetes clinic across both South East Coast (East & West) Networks were requested to show their hypo supplies, glucose meter & strips and bolus insulin present with them. Non-type 1 patients were not included in analysis due to small numbers. Non-identifiable patient data like age, sex, duration of diabetes, post code and HbA1c were collected.

Results: 405 patients (87.9%) attended their appointment; and 52.4% were male. Age significantly differed between attenders (mean=12.07, SD=4.05) versus non-attenders (mean=14.66, SD=3.37) (P<0.001); but no difference observed with gender or duration of diabetes. Patients age ranged from 1.5 years to 19 years (mean=12.39, SD=4.06) and duration of diabetes from 0.2 to 17 years (mean=4.87, SD=3.93). HbA1c ranged from 30-130 mmol/mol (mean=65.33, SD=17.88). Patients on 4+ injections had higher HbA1c (mean=67.34, SD=17.73) (mmol/mol) than those on pump therapy (mean=58.98, SD=11.96) (P<0.001). 399 patients were checked and 308 (77.2%) had one or more hypo supplies with them (49.5% glucose tablets, 38.7% glucose drink and 31.3% sugar jelly beans). Patients with higher HbA1c were less likely to have hypo supplies (P<0.001). Older children and patients with longer duration of diabetes had higher HbA1c (both P<0.001). No correlation was observed between HbA1c and gender or having bolus insulin present (P>0.281).

Conclusions: The majority of patients carried their hypo supplies with them. This study was conducted without fore-warning and very likely represents real life practice. Continued and targeted education for older children, those with longer duration of diabetes and higher HbA1c is needed, to promote good diabetes self-care.

Acknowledgement: Sincere thanks to all colleagues and diabetes teams across SEC networks for supporting this audit.