Conference Resources | Abstracts
September 3
rd
– 6
th
, 2014 | Toronto, Canada |
242
P154
Comparing two transition pathways: influence on diabetes outcome measures
K. Atkinson
1
, I.F. Anekwe
1
, C. Agwu
1
1
Sandwell General Hospital, Birmingham, United Kingdom
Objectives:
To examine the outcomes for patients undergoing transition to adult care. Locally there
are two different clinic set ups. One (City) is a young adult clinic for patients 16-24yr staffed by both
paediatric and adult clinicians. The other (Sandwell) has a single transfer clinic where care is formally
handed over to the adult team. Both have the same transition policy and preparation for transition and
serve a similar population. Difference in outcome between the sites would be useful to inform service
design as there is currently a lack of research evidence to inform the best model for transition clinics.
Methods:
20 City (C) & 29 Sandwell (S) pts were transferred to sole adult care 2010-2012. Mean age
17 yrs at City and 18yrs at Sandwell. We calculated the median HBA1c for each service before and
after transfer. Paired T test was used to compare service mean HBA1c. Chi squared test was used to
compare the % of patients lost to follow up, % of pts that improved HBA1c, % that achieved HBA1c of
< 58mmol/l, DKA rates and hypoglycaemia admissions 1 and 2 years after transfer.
Results:
Median HBA1C was worse both sites 1yr following transfer but this was not significant. There
was no significant difference in the 2 sites in % of pts achieving ideal HBA1C or improving their HBA1c
following transfer. However a significant number of Sandwell pts were lost to follow up at time of audit
compared to City (14/29 vs 3/20) (p< 0.5). No patients had admission with DKA or hypoglycaemia in
the 2yrs pre transfer. Post transfer 2 Sandwell patients were admitted with DKA and 1 City patient was
admitted with hypoglycaemia.
1Y pre
transfer S
1Y Pre
transfer C
1Y Post
transfer S
1Y post
transfer C
2Y Pre
transfer S
2Y pre
transfer C
2Y post
transfer S
2Y post
transfer C
Median
HbA1C
mmol/L
75
73
76.9
81
78.6
79
76.5
78.75
% patients
with
HbA1C
<58mmol/L
18%
10.5%
8.3%
5.2%
8%
6%
5%
6%
% with
improved
HbA1 after
transfer
39%
31%
55%
30%
[HbA1C outcomes]
Conclusions:
This patient population had poor control which did not change with clinic set up,
however there was significantly better retention with the joint young adult clinic set up at City.
