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Home management versus inpatient care of adolescents with newly diagnosed type 1 diabetes mellitus: survey of current practice
  1. J C Agwu
  1. Dept of Paediatrics, Sandwell Hospital, Sandwell and West Birmingham Hospital, West Bromich B71 4HJ, UK; sagwu22890aol.com

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    I read with interest the article written by Lowes and Gregory1 on the above subject. In 2003, I carried out a postal survey in order to document the current practice of paediatricians when managing adolescents newly diagnosed with type 1 diabetes mellitus. A total of 117 consultant paediatricians, mainly members of the British Society of Paediatric Endocrinology and Diabetes, were asked to complete a questionnaire indicating their current practice. Statistical analysis was made by MINITAB; χ2 and trend χ2 were used to examine the factors that affected the management option chosen by the paediatricians.

    Sixty eight per cent (80/117) replied. When faced with a well 12 year old child newly diagnosed with diabetes mellitus, the majority (47.5%) will offer a short admission (<2 days) followed by home based management and outpatient reviews, while 32.5% will offer complete home based management with no hospital admission. A minority (20%) did not offer any home based management at all. There was no significant difference between paediatricians that worked in a tertiary hospital and those that worked in a district general hospital in the choice of management (p = 0.4). In addition, the ratio of diabetes nurse specialists to number of patients in the clinic made no difference to choice (p = 0.09). However, using trend χ2, we found that units that had two or more diabetes nurse specialists were significantly more likely to offer home based care (p = 0.007).

    Since the earlier survey in 1988,2 it appears that more UK paediatricians are offering home based management of newly diagnosed children with diabetes mellitus. In this study, the majority are choosing to offer this after a short hospital admission.

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    • Competing interests: none declared

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