Abstract
Aims To describe clinic management and referral pathways among adults with type 1 diabetes (T1D) aged > 25 years attending a public outpatient diabetes service. Methods Retrospective cohort study of people with T1D aged > 25 years seen by endocrinologists in one Australian urban public outpatient in 2017. Electronic and paper medical records were reviewed using a dataset adapted from the UK National Institute for Health and Care Excellence 2015 guidelines. Results Among the 111 people with T1D (mean age 41 +/- 13 years, 55% men, mean body mass index 27.1 +/- 5.6 kg/m(2)), mean HbA1c was 8.1 +/- 1.9% (66 +/- 19 mmol/mol) (lower than the Australian National Diabetes Audit: 8.5%/69 mmol/mol) with 25.5% meeting the guideline target of < 53 mmol/mol (7.0%). Most people had seen a diabetes educator (80.2%) or dietitian (73.0%) and had complication screening. Complication rates were high (nephropathy 20.4%, retinopathy 27.4%, peripheral neuropathy 30.1%, ischaemic heart disease/acute infarction 10.5%). Overall, 27% of referrals occurred following an acute inpatient admission or emergency department presentation and 13% for management of diabetes in pregnancy. Conclusions A high proportion of people with T1D accessed public specialist care either during pregnancy or after a largely avoidable acute glycaemia-related hospital presentation. Subsequent care was in line with national specialist standards. This area has a "wait for acute event" rather than "complication prevention" model of care, associated with under-referral to the local multidisciplinary specialist service. Understanding how widespread this model of care is, and ways to reduce its prevalence, are urgently required.
Original language | English |
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Article number | 143 |
Number of pages | 10 |
Journal | BMC Endocrine Disorders |
Volume | 22 |
Issue number | 1 |
DOIs | |
Publication status | Published - 2022 |
Open Access - Access Right Statement
This article is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.Fingerprint
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Type 1 diabetes management and hospitalisation in the over 25’s at an Australian outer urban diabetes clinic
Patel, S., Farkash, C. & Simmons, D., figshare, 2022
DOI: 10.6084/m9.figshare.c.6023853.v1, https://springernature.figshare.com/collections/Type_1_diabetes_management_and_hospitalisation_in_the_over_25_s_at_an_Australian_outer_urban_diabetes_clinic/6023853/1 and one more link, https://springernature.figshare.com/collections/Type_1_diabetes_management_and_hospitalisation_in_the_over_25_s_at_an_Australian_outer_urban_diabetes_clinic/6023853 (show fewer)
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