P239 Quality of outpatient care received by children and young people with type 1 diabetes mellitus (T1DM) in a peripheral hospital

Introduction Type 1 Diabetes Mellitus (T1DM) is a common health condition affecting children and young people. T1DM is managed largely in the outpatient setting. Regular and ongoing outpatient care is essential to maintain optimal glycemic control and to monitor for complications. Aims The objective of this study was (1) to examine the quality of outpatient care received by children and young people with T1DM in a peripheral hospital and (2) to suggest ways to improve the service in peripheral hospitals in Ireland. A re-audit could be done after implementation of such suggestions. Methods This was a retrospective study where patients (0 to 16 years old) with T1DM were identified by an electronic search of the Hospital In-Patient Enquiry (HIPE) system between 01/01/2017 to 31/12/2018. Statistical analysis was completed using Microsoft Excel 2011. Results We identified 52 patients, 33 males (63%) and 19 females (37%). The median age of the patients was 12 years. 33 patients (63%) were under ‘shared care’ with a tertiary centre. During the study period, the median number of OPD appointments was 4 (with a standard deviation of 2.2). The International Society for Paediatric and Adolescent Diabetes (ISPAD) Clinical Practice Consensus Guidelines 2014 Compendium recommends an HbA1c target of 80 mmol/mol). 13 (25%) patients did not have a lab HbA1c measured during the study period. ISPAD recommends screening thyroid function every second year in asymptomatic individuals and screening for celiac disease every 1–2 years. 8 patients (15%) did not undergo thyroid function screening during the study period. 9 patients (17%) did not undergo screening for celiac disease during the study period. Conclusion The results of this study highlight ‘good glycemic control’ was less frequent and ‘poor glycemic control’ was more frequent in our patient population. Further, this study highlights a lack of consistency in screening for diabetes-associated conditions. Currently, children and young people with T1DM attend a general paediatrics outpatient clinic at our hospital. This patient population would benefit greatly from a paediatrics diabetes specific clinic. Additional ways to improve the service locally include adding a ‘T1DM care’ performa to charts for all clinics visits.This would ensure a systematic approach to the assessment and management of children and young people with T1DM.