Endocrine Abstracts

Background: The challenges of caring for young children under 7 years old with type 1 diabetes are widely acknowledged. Very young children are dependent on caregivers for their diabetes care, the burden of which can have a detrimental effect on psychosocial well-being. Significant glucose variability (GV) can negatively impact early brain development and increase long-term complication risk. Use of advancing technology, specifically hybrid closed loop (HCL) systems, is recommended to minimise GV, optimise time in range (TIR, 3.9-10 mmol/l) and HbA1c outcomes. Having ascertained demand for a dedicated under 7’s service, the Leeds Children’s and Young Persons Diabetes team aimed to explore a holistic approach to supporting families through the introduction an under 7’s clinic.

Method: Dinky-Betes started in July 2023; a monthly play-centred clinic facilitated by the multi-disciplinary team including a diabetes play specialist and clinical psychologist. A tailored pedagogical approach using age-appropriate themed activities supports child social and emotional development and diabetes understanding. Dinky-Betes also actively promotes peer support. Clinical outcomes including HbA1c and continuous glucose monitoring (CGM) data are being collected alongside child and parental quality of life (QoL) scores using an adapted Likert scale and T1DAL measure respectively.

Results: 32 families have accessed the Dinky-Betes clinic including 11 patients in their first year of care. All patients are on CGM with 28 on HCL. Preliminary results demonstrate a reduced median HbA1c (55.5 to 53.0 mmol/mol), improved median TIR (62% to 63.0%), and stable median time below range of 3.0% and GV (SD; < 3.0) of 3.5. Preliminary thematic analysis has identified three QoL themes for further evaluation; every child as an individual, supportive factors in diabetes and diabetes and relationships. Peer support helps children try technology/move sites; develop “diabetes friends”, share feelings and want to come and engage in clinic; and parents have shared experiences, learning from and with each other.

Conclusions: The holistic approach of Dinky-Betes supports the psychosocial development of children in relation to their diabetes and other important aspects of their lives. The clinic has provided valuable peer support for children, families and staff and has optimised use of HCL and clinical outcomes.