Improving glycaemic outcomes in newly diagnosed Type 1 diabetes adults

Summary

A 2014 audit of Sheffield Teaching Hospital NHS Foundation Trust found that glycaemic outcomes for type 1 diabetes (T1DM) patients were sub-standard and potentially damaging. Even at one-year post-diagnosis, only 23% of patients were achieving the NICE target of <58mmol/mol vs 27% for all durations of T1DM in the 2012 National Diabetes Audit. The existing patient care pathway was reviewed, and a consensus exercise undertaken to develop a clear evidence-based protocol. Results show significant improvements in glycaemic control compared with those diagnosed 2012-2013, and there is a more than two-fold increase in the proportion of patients achieving the NICE target. Staff and patient feedback has been highly positive, with expectations of staff often exceeded, and 85% of patients being on the recommended insulin regimen.

Challenge

Sheffield T1DM patients were found to be at increased risk of complications compared to the national average – therefore the Trust's service was not as effective as it ought to be. Good glycaemic control is the cornerstone of T1DM management, in order to reduce devastating microvascular complications of diabetes, as shown by the Diabetes Control and Complications Trial (DCCT). Results from the EDIC study (a follow-up of DCCT) showed that there is a legacy effect, ie good control from diagnosis is beneficial, even if control in later years is poorer.

Objectives

To reduce the mean 12-month HbA1c of newly diagnosed T1DM patients, by establishing a clear and consistent pathway which could be implemented across the two acute hospitals within the Trust.

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QiC Diabetes Winner 2016
Patient Care Pathway – Adults
Improving glycaemic outcomes in newly diagnosed Type 1 diabetes adults
by Sheffi eld Teaching Hospital NHS Foundation Trust

Contacts

Dr Jackie Elliott

Job title:
Senior Clinical Lecturer in Diabetes and Honorary Consultant
Place of work:
Sheffield Teaching Hospital NHS Foundation Trust
Telephone:
0114 271 4990
Email:
j.elliott@sheffield.ac.uk

Resources

STH PROUD Values.pdf - 267.4 KB
Patient 'Journey'.pdf - 203.1 KB

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