Endocrine Abstracts

Introduction: Optimal care in Type 1 Diabetes (T1DM) requires intensive insulin management with regular dose adjustments. A Download clinic (DC) was created for all patients attending the Paediatric Diabetes clinic. Patients downloaded their glucometers, pumps and Continuous Glucose Monitors (CGM) either at home or hospital. After analysis, the diabetes team provided feedback by email and phone.

Objectives: To analyse the effects of the DC on the metabolic control of paediatric patients with T1DM

Methods: Retrospective study of all patients using the DC during its first 9 months of existence. Demographic, clinical and metabolic control data was recorded at the beginning and during 3 months follow up. Patients in partial remission, diagnosed within the past 6 months or with less than 2 DC were excluded. Primary outcome was the difference in HbA1c levels. Secondary outcomes were differences in hypoglycaemic events, average daily blood glucose testing, average blood glucose level and total daily insulin dose (TDI).

Results: 21 (11 female) out of 39 patients fulfilled the study’s conditions. Median age was 9 years old (min 3 – max 15). Median time of diagnosis was 3.9 yrs (min 1 – max 13.15). Median clinics per patient was 3 (min 2 – max 8). When DC started, 6 patients were on multiple daily injections (MDI), 15 had insulin pumps (IP), four of which had CGMs. One patient changed from MDI to IP two weeks after initiating DC. Median HbA1c significantly decreased from 8.1% (min 7.50 – max 12.4) to 7.91% (min 7 – max 9.74) after 3 months (P<0.05). Mean TDI/Kg significantly increased from 0.74 (SD 0.3) to 0.82 (SD 0.3) after 3 months (P<0.05). There was no statistical significance in hypoglycaemic events, average blood glucose levels and testing before and after using the DC. No patient required medical care because of poor metabolic control.

Conclusion: This study demonstrates an improvement of patients’ HbA1c level after using the DC without significant increase of adverse events revealing a potential benefit of DC clinics in metabolic control of Diabetic patients.