An assessment of care of paediatric and adolescent patients with diabetes in a large district general hospital

Autor: E. Wilson, J. Anderson, V. Baskar, T. A. M. Abdu, D. Kamalakannan, K. Gone, Harit Buch, D. M. Barton
Rok vydání: 2003
Předmět:
Zdroj: Diabetic Medicine. 20:394-398
ISSN: 0742-3071
DOI: 10.1046/j.1464-5491.2003.00947.x
Popis: Aims To assess the process of clinical care and outcomes of young patients with diabetes attending clinics at a large district general hospital. Methods Retrospective analysis of data obtained from 106 case notes of patients aged 12–22 years attending the paediatric, combined adolescent or adult diabetes clinics between 1998 and 2000. The frequency of follow-up, rate of admission, glycaemic control, systolic blood pressure, weight change and screening for complications were assessed. Results The mean attendance rate was 78%. The admission rate was 91 admissions per 1000 patient years. Overall, the mean HbA1c was 9.1% with only 15% of paediatric and adolescent patients having mean HbA1c≤ 8.0%. Mean systolic blood pressure was 124 mmHg. There was a significant increase in obesity with mean weight for height at diagnosis increasing from 89% to 111% after 7 years of diabetes. Mean daily insulin dose was 1.51 U per kg body weight and decreased with increasing age. Screening for complications and associated conditions was variable: 91% for retinopathy, 86% for foot problems, 64% for thyroid dysfunction, 22% for coeliac disease and 10% for microalbuminuria. The overall rate of retinopathy was low at 4% of those screened. Conclusions Providing satisfactory care for young people with diabetes remains a difficult challenge. Although the complication rate observed was low in this group, the most important issues are the need for improvement in glycaemic control, weight gain and high drop-out rate. Diabet. Med. 20, 394–398 (2003)
Databáze: OpenAIRE
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