Clinical care and other categories posters: Secondary care

Diabetes, homelessness and hospital admissions

D Hurrell¹, J Kennon², B Kennon²

¹Podiatry Department, Homeless and Asylum Health Services, Glasgow, UK, ²Diabetes Centre, Queen Elizabeth University Hospital, Glasgow, UK

Aims The aim of this study was to examine hospital admissions in individuals with diabetes experiencing homelessness. Individuals who experience homelessness have chaotic lifestyles and access medical input at times of crisis. Those with diabetes are at greater risk however despite this very little is known about hospital admissions in this vulnerable group.

Methods We performed a retrospective audit from 1 January 2017 to 31 August 2019 of hospital admissions for 27 homeless individuals with diabetes who have attended outreach podiatry services. Data on admissions were obtained from SMR01 records and other clinical data from case notes.

Results Mean age was 45 years. 63% (n=17) were male. Mean duration of diabetes was 6.5 years and 26% had type 1, 48% type 2 and 26% pancreatic diabetes. 81% had a history of alcohol and/or substance misuse and 48% a co-existing mental health condition. There were a total of 248 admissions. This equates to 1,718 days spent in hospital in total and 93 admissions per year. The mean length of stay was 7 days (range 0–163). Diabetes is listed as a primary or secondary condition in 27% (n=66) of admissions. The leading cause of a diabetes admission was DKA in 23 cases, followed by 8 for hyperglycaemia and 4 with hypoglycaemia.

Conclusion Individuals who are homeless and have diabetes are admitted to hospital frequently, often presenting at point of crisis following non-engagement with mainstream services. Outreach care models which better support this vulnerable group are likely to improve person-centred care and reduce demand on unscheduled care.

SUPPORTING INFORMATION The conference poster for this abstract is available online in the Supporting Information section at the end of this page.