Diabetes care provision and glycaemic control in Northern Ireland: a UK regional audit

被引:24
作者
Cardwell, CR
Patterson, CC
Allen, M
Carson, DJ
机构
[1] Queens Univ Belfast, Dept Epidemiol & Publ Hlth, Belfast BT12 6BJ, Antrim, North Ireland
[2] Queens Univ Belfast, Dept Child Hlth, Belfast BT7 1NN, Antrim, North Ireland
关键词
D O I
10.1136/adc.2004.061150
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Aims: To assess the care received, compared to national guidelines, and to investigate factors associated with glycaemic control in children and adolescents with type 1 diabetes attending clinics in Northern Ireland. Methods: An audit of the care provided to all patients attending 11 paediatric diabetes clinics commenced in 2002. A research nurse interviewed 914 patients completing a questionnaire recording characteristics, social circumstances, and aspects of diabetes management, including the monitoring of complications and access to members of the diabetes team. Glycaemic control was measured by glycosylated haemoglobin (HbA(1c)), determined at a DCCT aligned central laboratory. Results: The average HbA1c concentration was 8.8% (SD 1.5%), with 20% of patients achieving recommended HbA1c levels of less than 7.5%. In the year prior to the audit, 76% of patients were reviewed by a diabetes specialist nurse and 42% were tested for microalbuminuria. After adjustment for confounding factors, better glycaemic control was identified, particularly in patients who had attended exactly four diabetes clinics in the previous year, were members of the patient association Diabetes UK, and lived with both natural parents. Conclusions: In Northern Ireland only a minority of patients achieved recommended HbA1c levels. Furthermore, children and adolescents with diabetes were reviewed by fewer specialists and were less intensively monitored for microvascular complications than recommended. There was evidence of better control in children who were members of Diabetes UK, suggesting that parental attitude and involvement could lead to benefits.
引用
收藏
页码:468 / 473
页数:6
相关论文
共 30 条
[1]  
Alexander V, 2001, DIABETES CARE, V24, P239
[2]   Social disadvantage, family composition, and diabetes mellitus: prevalence and outcome [J].
Baumer, JH ;
Hunt, LP ;
Shield, JPH .
ARCHIVES OF DISEASE IN CHILDHOOD, 1998, 79 (05) :427-430
[3]   Audit of diabetes care by caseload [J].
Baumer, JH ;
Hunt, LP ;
Shield, JPH .
ARCHIVES OF DISEASE IN CHILDHOOD, 1997, 77 (02) :102-107
[4]  
*BRIT DIAB ASS, 1995, PRINC GOOD PRACT CAR
[5]   DEPRIVATION AND MORTALITY - AN ALTERNATIVE TO SOCIAL-CLASS [J].
CARSTAIRS, V ;
MORRIS, R .
COMMUNITY MEDICINE, 1989, 11 (03) :210-219
[6]   Predictors of glycaemic control and hypoglycaemia in children and adolescents with type 1 diabetes from NSW and the ACT [J].
Craig, ME ;
Handelsman, P ;
Donaghue, KC ;
Chan, A ;
Blades, B ;
Laina, R ;
Bradford, D ;
Middlehurst, A ;
Ambler, G ;
Verge, CF ;
Crock, P ;
Moore, P ;
Silink, M .
MEDICAL JOURNAL OF AUSTRALIA, 2002, 177 (05) :235-238
[8]   Glycated hemoglobin and related factors in diabetic children and adolescents under 18 years of age: A Belgian experience [J].
Dorchy, H ;
Roggemans, MP ;
Willems, D .
DIABETES CARE, 1997, 20 (01) :2-6
[9]   THE CHILD, THE ADOLESCENT, AND THE DIABETES CONTROL AND COMPLICATIONS TRIAL [J].
DRASH, AL .
DIABETES CARE, 1993, 16 (11) :1515-1516
[10]   CROSS-SECTIONAL STATURE AND WEIGHT REFERENCE CURVES FOR THE UK 1990 [J].
FREEMAN, JV ;
COLE, TJ ;
CHINN, S ;
JONES, PRM ;
WHITE, EM ;
PREECE, MA .
ARCHIVES OF DISEASE IN CHILDHOOD, 1995, 73 (01) :17-24