Endocrine Abstracts

There is little evidence of glycaemic control changes in Paediatric patients with diabetes during pandemics or natural disasters. We were interested in analysing and comparing the HbA1c values in children and young people with diabetes at West Hertfordshire NHS trust before the covid-19 pandemic in 2019-2020 and during lockdown in 2020-2021. Our hypothesis was that there would be a deterioration in HbA1c outcomes and a reduction in the number of tests done in 2020-2021. We assessed number of HbA1c measurements, mean and median on 204 patients under 19 years of age and the impact of using innovative ways of measuring HbA1c. Results showed a significant decrease in number of Hba1C tests during the months of lockdown, from 655 pre lockdown to 450 (p0,005) after. There was also a decrease in the number of tests done per patient, with average of 3.31 tests before and 2.11 after. However, significant increases in HbA1c testing were seen during the period when innovative ways of drive-through and walk-in clinics were introduced tripling and doubling number of measurements, respectively. The mean HBA1c was significantly lower from March 2020 to March 2021 at 65.23 mmol/mol compared to 69.93 mmol/mol in the previous year (p0.019). In conclusion, the innovative ways of testing HbA1c measurement, can be of value during natural disasters and pandemics but may also be of benefit and add flexibility for the patients as the diabetes services are reconstructed post pandemic restrictions. We cannot say for certain what improved the HbA1C significantly during lockdown. One hypothesis is that the lower mean HbA1c values were because patients with better glycaemic control historically were more likely to attend for the HbA1c tests. We had seen a higher percentage of patients with a mean HbA1C of more than 80 mmol/mol (12% vs 29%) in the previous year and patients that did not attend in the year of lockdown had a considerably higher mean 76.8 mmol/mol (p:0.3). However, we would need further individual patient analysis to confirm this. We also propose that it would be helpful to conduct a survey of patients and their parents to find out other contributing factors.