Article Text
Abstract
Aims We conducted a postal survey of paediatric diabetic units in NHS Hospitals across the United Kingdom regarding their practise of evaluation and management of hypertension in paediatric patients with both Type 1 and Type 2 diabetes.
Methods A questionnaire was sent to different units across the UK. Addresses of units were identified from the directory of diabetic care 2008. Questionnaires were sent to 151 units in month of June 2012. Response was awaited for 12 weeks. 69 responses were received. The data were analysed using Microsoft excel.
Results Out of 151 units 69 units replied, giving a response rate of 45%. Of the units that replied, 10% of the units have written guidelines. 88% of the units have some form of age and height based chart to identify hypertension. 50% of the units check blood pressure annually during diabetic annual review whilst other more frequently. Only 45% of the units consider microalbuminuria as a trigger to initiate investigation. 73% of the units undertake 24 hours ambulatory blood pressure monitoring prior to starting antihypertensive therapy. For further confirmation and management of hypertension 62% of the units refer these children for joint management with nephrologist. Our survey revealed a wide variation and inconsistencies in practise of evaluation and management of hypertension in this high risk patient group. There is also a variation in the choice of antihypertensive medication amongst different units.
Conclusion There is a need for national consensus on evaluation and management of hypertension in children with diabetes which will help in standardisation of the care and consequently reduce the morbidity related to its long term complications.