Endocrine Abstracts

HbA1c is a critical marker of long-term glycaemic control and is pivotal in managing diabetes-related complications. Appointment adherence plays a crucial role in diabetes management, enabling healthcare providers to monitor and address patient needs effectively. This audit investigates the correlation between appointment adherence and HbA1c levels in Young Adult Diabetes Clinic patients while also identifying patient characteristics associated with high DNA (Did Not Attend) rates. A retrospective analysis was conducted on 63 patients who attended the Young Adult Diabetes Clinic at a teaching hospital, from age 19 until November 2023. Data was retrieved from the Trust surgery database, encompassing a comprehensive range of potential influencing factors such as the presence of underlying comorbidities, blood pressure (BP), total cholesterol to HDL ratio, and body mass index (BMI). The study population had a mean age of 21.6 years and was predominantly diagnosed with Type 1 diabetes, with most patients on insulin therapy. Analysis revealed a significant correlation between high DNA rates and poor HbA1c control. Patients missing 81-100% of appointments exhibited the highest HbA1c levels (>76 mmol/l), indicating suboptimal glycaemic control. Conversely, patients with 0-20% DNA rates demonstrated better glycaemic control. Key factors influencing appointment adherence included educational attainment, employment status, and distance to the clinic. Higher non-adherence rates were observed among patients from lower educational backgrounds and those with substantial work-related commitments. This audit underscores the importance of regular clinic attendance in managing diabetes effectively, highlighting the need for targeted interventions to improve adherence. Effective glycaemic control is vital to mitigate the risk of diabetes-associated cardiovascular disease (CVD). The ’SEARCH’ study has emphasised the higher CVD risk in young patients with diabetes, underlining the necessity of regular monitoring to maintain optimal HbA1c control (Hamman et al.). Practical solutions proposed include tailoring clinic appointments to patients’ schedules, introducing psychosocial support for patients over 19 years old, and promoting multidisciplinary approaches. Implementing a gamified application could engage the younger demographic by incentivising attendance at medical appointments. Such applications could allocate points for each attended appointment, redeemable for rewards, thereby promoting adherence to regular healthcare visits.