Aims: To assess the care received, compared to national guidelines, and to inv estigate factors associated with glycaemic control in children and adolescents w ith type 1 diabetes attending clinics in Northern Ireland...Aims: To assess the care received, compared to national guidelines, and to inv estigate factors associated with glycaemic control in children and adolescents w ith type 1 diabetes attending clinics in Northern Ireland. Methods: An audit of the care provided to all patients attending 11 paediatric diabetes clinics comme nced in 2002. A research nurse interviewed 914 patients completing a questionnai re recording characteristics, social circumstances, and aspects of diabetes mana gement, including the monitoring of complications and access tomembers of the di abetes team. Glycaemic control was measured by glycosylated haemoglobin (HbA1c), determined at aDCCT aligned central laboratory. Results: The average HbA1c concentration was 8.8%(SD 1.5%), with 20%of patients achiev ing 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 teste d for microalbuminuria. After adjustment for confounding factors, better glycaem ic control was identified, particularly in patients who had attended exactly fou r diabetes clinics in the previous year, were members of the patient association Diabetes UK, and lived with both natural parents. Conclusions: In Northern Irel and only a minority of patients achieved recommended HbA1c levels. Furthermore, children and adolescents with diabetes were reviewed by fewer specialists and we re 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.展开更多
文摘Aims: To assess the care received, compared to national guidelines, and to inv estigate factors associated with glycaemic control in children and adolescents w ith type 1 diabetes attending clinics in Northern Ireland. Methods: An audit of the care provided to all patients attending 11 paediatric diabetes clinics comme nced in 2002. A research nurse interviewed 914 patients completing a questionnai re recording characteristics, social circumstances, and aspects of diabetes mana gement, including the monitoring of complications and access tomembers of the di abetes team. Glycaemic control was measured by glycosylated haemoglobin (HbA1c), determined at aDCCT aligned central laboratory. Results: The average HbA1c concentration was 8.8%(SD 1.5%), with 20%of patients achiev ing 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 teste d for microalbuminuria. After adjustment for confounding factors, better glycaem ic control was identified, particularly in patients who had attended exactly fou r diabetes clinics in the previous year, were members of the patient association Diabetes UK, and lived with both natural parents. Conclusions: In Northern Irel and only a minority of patients achieved recommended HbA1c levels. Furthermore, children and adolescents with diabetes were reviewed by fewer specialists and we re 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.
