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Abstract
Aims To make young people more self-reliant during their transitional years through use of technology.
Methods The paediatric diabetes multi-disciplinary team (MDT) looks after 245 patients with diabetes under 19 years of age in three different hospital sites. The MDT has increasingly used technology in the form of continuous subcutaneous insulin infusion (CSII), continuous glucose monitoring (CGM), Diasend and Carelink Professional software in diabetes management. Texts/emails are widely used as forms of on-going communication in between clinical encounters. Funding was secured so that all 4 major insulin pump models were made available to patients and pump demo sessions facilitated patient choice. CGM is used in patients with hypoglycaemia unawareness, severe hypoglycaemia and in managing blood sugars in high performance athletes. Patients are encouraged to use Diasend to download their pump data at home and communicate with the MDT via text/email to make changes to their insulin therapy. Diasend is also used in clinics to facilitate patient focussed consultations. A diabetes specific online encrypted database was created to log in every single patient contact. This makes information readily available to the entire team at all sites, collect performance data for service evaluation, planning and submission to national paediatric diabetes audit.
Results
49% of patients in transitional care (39 out of 79) are on CSII, which is well above national average.
Patient Reported Experience Measures (PREMS) demonstrated increased patient engagement and confidence in the team.
Audit of patients on CSII showed an average drop of HbA1c from 74 mmol/mol to 68mmol/mol (Figure 1)
The diabetes peer review highlighted ‘number of patients on pumps’, ‘out of hours nurse support’ and local database as ‘good practice’.
The results were disseminated within the region and were cited as good practice by South East Coast Strategic Clinical Network and were also presented at the Royal College of Physicians Transitional care conference.
Conclusions Young people leaving our transitional care are increasingly more confident and self-reliant in managing their diabetes.
