Endocrine Abstracts

Background: “Diabetes (type 1 and type 2) in children and young people: diagnosis and management” guideline (NICE NG18, 2015) stipulates following “Coeliac disease: recognition, assessment and management” guideline (NICE NG20, 2015) for follow up children and young people (CYP) with diabetes and coeliac disease. NG20 advocates against checking coeliac antibodies on yearly basis if compliance with gluten free food is confirmed by dietary review. In 2016, we audited annual review of CYP with type 1 diabetes and coeliac disease compliance with NG20. The results showed that 80% of these CYP had coeliac serology checked (20% compliance with standard). Action plan included raising awareness about NG20 and changing diabetes annual review investigations panel in pathology requesting system.

Aim: Re-audit to assess progress following the implementation of changes based on the results and recommendations of the initial audit.

Standard: NICE NG20: CYP with coeliac disease should have annual review of symptoms, weight and height measurement and dietitian assessment of compliance with gluten free food. Routine serologic testing is not indicated.

Methodology: Patients with T1DM and coeliac disease attending the Paediatric Diabetes clinic in our hospital between 1/4/2018 to 31/3/2019 were identified, and their annual review processes data was extracted from electronic patient records.

Results: The re-audit showed 100% compliance with review of symptoms, weight & height measurement, and serology testing. Compliance with dietetic review was 77.78% attributed to limited dietetic resource availability.

Conclusion: A small change in pathology investigation request profile increased compliance with coeliac serology testing standard from 20% to 100%.