Endocrine Abstracts

Aim: To investigate the trend of HbA1c levels of newly diagnosed type 1 diabetes paediatric patients in Gloucestershire Hospitals NHS Foundation Trust.

Methodology: The Infoflex diabetes database was used to collate information on the type 1 diabetes paediatric patients, diagnosed in Gloucester NHS Trust between September 2015 and December 2017. The cohort totalled 74. Their HbA1c levels at diagnosis, 4–7 weeks, 3–4 months, 6–8 months and 12–16 months were recorded and compared. The cohort was sub-divided into smaller subgroups so that the outcomes for different age groups and genders could be calculated and compared. These groups were: boys; girls; 0–4 years; 5–9 years; 10–14 years; and ≥15 years old. Outpatient appointments and any other contact with the diabetes team were recorded in the first 12 weeks.

Results: At 12 weeks post diagnosis, the mean HbA1c for the whole cohort was 47.39 mmol/mol which is below the target level (≤48 mmol/mol). At 6–8 months and 12–16 months the mean HbA1c level of the cohort was 52.71 mmol/mol and 58 mmol/mol respectively. These were above the target level. The 10–14-year-old group at 12 weeks was the only age group to achieve a mean HbA1c level below the target (44.89 mmol/mol). The mean number of contacts with the diabetes team in the first 12 weeks was 31.97 for boys and 34.69 for girls.

Conclusion: The post-diagnosis interventions were effective in improving the HbA1c levels for all the sub groups. However, sustaining the HbA1c level below target over a longer period was problematic. Increasing age in itself does not appear to be an exacerbating factor as the most successful group in this audit was the 10–14-year-old age group. The HbA1c level for boys was consistently lower at all check points than for girls. There appears to be no correlation between the number of contacts with the diabetes team and improved HbA1c level control.