Endocrine Abstracts

Diabetic nephropathy is a major cause of end stage renal failure requiring haemodialysis. Diabetes patients undergoing haemodialysis are at a high risk of adverse cardiovascular outcomes and therefore require close follow-up and ongoing monitoring which involves clinical staff working on dialysis units, GPs and diabetic nurses/specialists. We conducted an audit to assess service provision given to dialysis patients at Doncaster Royal Infirmary as per JBDS guidelines. This was a questionnaire led audit and involved enquiring whether patients are under the care of a named DSN, aware of insulin reduction on the day of dialysis, undergo routine retinal and lipid screen and to assess general control of their diabetes. We found that of the patients receiving dialysis at Doncaster Royal Infirmary, 40% of patients had not been seen by diabetes team, 55% were not under a named DSN, 80% were not aware of dose reduction while 90% of patients had undergone routine eye and lipid screening. Following this audit, we have made certain recommendations to improve the standard of care given to dialysis patients. This included individual patient education, making appropriate referrals and active communication with the Diabetic team to ensure close follow-up. Our next step would be to re-audit this cohort to ascertain improvement.