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Endocrinology and diabetes

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G/TUES/END1 A DECADE OF TRENDS IN CHILDHOOD DIABETES IN WESSEX 1996 TO 2005

M. Riddle, presenting, A. McAulay, S. Payne, P. Thomas.Poole Hospital NHS Trust, Poole, Dorset, UK

Aim: To analyse data collected for children with diabetes <16 years in the Wessex region and assess significant trends from 1996 to 2005.

Method: Data were collected annually by questionnaire from each of the 10 districts on: occurrence rates, length of stay (LOS) and incidence of diabetic ketoacidosis (DKA) at presentation, re-admission rates with DKA, clinic staff numbers, and mean clinic HbA1c.

Results: There is a significant trend of increasing incidence (p = 0.001) and prevalence (p<0.001) of diabetes over the study period. The LOS for new patients (not in DKA) has shown a decrease (from 3.3 to 1.6 days), and varies between districts. This variation may be related to Paediatric Diabetic Nurse Specialist (PDNS) cover per patient (r = −0.54, p = 0.11). The incidence of DKA at presentation has remained constant (average = 23%). The re-admission rates of DKA show a downward trend (6% in 1996 to 3.7% in 2004), but were not statistically significant (p<0.2). The incidence of DKA re-admissions varies between districts from a mean of 2.1% to 9.6% in 2005. The incidence of DKA re-admissions is not directly related to PDNS cover per patient (r = −0.06, p = 0.88). The number of consultants per 100 patients varied between 5.5 and 0.9 across the districts in 1996 and between 2.7 and 0.65 in 2005. The PDNS ratio per 100 patients varied between 1.5 and 0.5 in 2005. Mean HbA1c levels varied between districts but different assays hinder comparison.

Conclusions: This is a large regional study providing 10 years of data. Both incidence and prevalence of childhood diabetes are increasing in the Wessex region. Fewer consultants are looking after more children. PDNS cover remains poor in some districts and may explain variation in LOS of new patients but not re-admission with DKA …

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