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Type 1 diabetes management and hospitalisation in the over 25's at an Australian outer urban diabetes clinic.
- Source :
-
BMC Endocrine Disorders . 5/31/2022, Vol. 22 Issue 1, p1-10. 10p. - Publication Year :
- 2022
-
Abstract
- Aims: To describe clinic management and referral pathways among adults with type 1 diabetes (T1D) aged > 25 years attending a public outpatient diabetes service. Methods: Retrospective cohort study of people with T1D aged > 25 years seen by endocrinologists in one Australian urban public outpatient in 2017. Electronic and paper medical records were reviewed using a dataset adapted from the UK National Institute for Health and Care Excellence 2015 guidelines. Results: Among the 111 people with T1D (mean age 41 ± 13 years, 55% men, mean body mass index 27.1 ± 5.6 kg/m2), mean HbA1c was 8.1 ± 1.9% (66 ± 19 mmol/mol) (lower than the Australian National Diabetes Audit: 8.5%/69 mmol/mol) with 25.5% meeting the guideline target of < 53 mmol/mol (7.0%). Most people had seen a diabetes educator (80.2%) or dietitian (73.0%) and had complication screening. Complication rates were high (nephropathy 20.4%, retinopathy 27.4%, peripheral neuropathy 30.1%, ischaemic heart disease/acute infarction 10.5%). Overall, 27% of referrals occurred following an acute inpatient admission or emergency department presentation and 13% for management of diabetes in pregnancy. Conclusions: A high proportion of people with T1D accessed public specialist care either during pregnancy or after a largely avoidable acute glycaemia-related hospital presentation. Subsequent care was in line with national specialist standards. This area has a "wait for acute event" rather than "complication prevention" model of care, associated with under-referral to the local multidisciplinary specialist service. Understanding how widespread this model of care is, and ways to reduce its prevalence, are urgently required. [ABSTRACT FROM AUTHOR]
- Subjects :
- *GLYCOSYLATED hemoglobin
*ENDOCRINOLOGISTS
*PERIPHERAL neuropathy
*HOSPITAL emergency services
*MYOCARDIAL ischemia
*TYPE 1 diabetes
*RETROSPECTIVE studies
*ACQUISITION of data
*URBAN hospitals
*BENCHMARKING (Management)
*TREATMENT effectiveness
*HOSPITAL care
*MEDICAL referrals
*MEDICAL records
*DESCRIPTIVE statistics
*BODY mass index
*DISEASE management
*OUTPATIENT services in hospitals
*LONGITUDINAL method
*ADULTS
Subjects
Details
- Language :
- English
- ISSN :
- 14726823
- Volume :
- 22
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- BMC Endocrine Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 157184125
- Full Text :
- https://doi.org/10.1186/s12902-022-01057-9