Endocrine Abstracts

Background: 71/270 (26%) of our patients with T1DM, diagnosed for more than 1 year, had an ideal HbA1c of less than or equal to 48 mmol/mol. Are there factors within this group that may be transferred into groups with higher HbA1cs to improve control?

Methods: Clinical records were reviewed for the whole year and download data from a randomly selected 2 week period was reviewed. Age, gender, time from diagnosis, ethnicity, postcode, other medical conditions, social care involvement and number of contacts with the diabetes team were recorded. From the download, information was collected on: CGM/FGS/fingerprick blood glucose (SMBG) use, mean SMBG tests per day and number and severity of SMBG hypos, time in target (CGM/FGS/SMBG). Data was not included for 2 patients (closed loop research trial) and was unavailable for 1 patient who did not consent to downloads being saved.

Results: 33/71 were female. Mean age was 11.5 yrs with 31/71 being teenagers. Mean duration of diabetes was 4 years and 4 months. 38/71 were treated with insulin pumps. Data from the two week period showed: mean number of daily SMBG tests was 6 for those not on CGM/FGS. Average time spent in target was 41%. Average number of hypos (<4.0 mmol/l) per patient was 7. Variability for all 3 factors, however, was large and there were no observed correlations. Hypoglycaemia was looked at in more detail. There were only 5 recorded SMBG levels under 2.5 mmol/l in total, with two thirds of SMBG readings being between 3 and 4 mmol/l. Contact with the diabetes team was overall much higher than the minimum specified by Best Practice Tariff (BPT) with the average being 32 (12–154).

Conclusion: Contact with the diabetes team was frequent in this group. This may be an important factor in enabling such high numbers to achieve an ideal HbA1c. We will look at our whole clinic cohort to determine whether this contact frequency has increased over time in line with improving clinic HbA1c.