PAEDIATRICS AND CHILD HEALTH POSTERS

¹Nepean Hospital, Penrith, New South Wales, Australia

Background: Adolescence is a challenging period for diabetes management particularly when transitioning to adult care. Depending on the referral source, there have been reports expressing concerns that transition to adult care may lead to poor glycaemic control and clinic attendances.

Aim: Comparison of compliance and outcome in adolescents with type 1 diabetes mellitus attending a co-located paediatric and transition diabetes service.

Methodology: A retrospective medical records review was conducted on patients with type 1 diabetes attending a transition clinic. Patients of the hospital's co-located paediatric diabetes clinic referred to the transition clinic were compared to the patients referred from other external paediatric diabetes clinics. Comparative statistics were used to analyse outcomes such as HbA1c, outpatient clinic attendances, complication rates and socioeconomic factors between the referral sources.

Results: Data was collected from 356 patients. 121 patients were referred from the co-located paediatric diabetes clinic (IRG) and 235 patients from external paediatric diabetes clinics (ERG). The HbA1c in the IRG was almost the same during the 6- and 12-months transition, whereas in the ERG there was an improvement in HbA1c at 6 months (P = 0.007) and 12 months (P = 0.025). 112 patients (92%) attended one or more appointments with the endocrinologist in the IRG compared to 182 patients (82%) in the ERG (P = 0.024).

Conclusion: Although co-location of a paediatric and transition clinic we hypothesised might improve patient attendance, this paradoxically did not equate to better glycaemic control following transition in our cohort. The underlying reason for this finding remains unclear but the major psycho-social, mental and metabolic health challenges that young persons with T1DM face are highlighted in our study.