Background: The UK has the highest number of children and young people with type 1 diabetes mellitus in Europe, but the lowest number of children and young people attaining good diabetes control.
Methods: In December 2012, our diabetes service established the use of an electronic diabetes information management system that was web-based (Twinkle.Net) and routine uploading of glucose meters and pumps (Diasend). The electronic management system Twinkle.Net allowed monthly audit by the diabetes team which identified specific patients who had poor metabolic control (HbA1c) and those who were recurrent non-attenders to clinic. These patients were identified for more intensive contact and education with the diabetes nurse specialists. The Diasend system allowed the diabetes team to upload and view patients data within all outpatient clinics. Clinical outcomes were compared in the period before and the period after the implementation of the electronic diabetes information management system and use of a routine uploading of patients blood glucose meters and insulin pumps.
Results: In 2012 prior to implementing the technology, the average HbA1c was 8.6% and in 2013 the average HbA1c was 8.4%. Hospital admissions due to diabetes was 22% in 2012 and 16% in 2013 (P<0.05). The median hospital length of stay for was 2.7 days in 2012 compared with 1.8 days in 2013 (P<0.05). A patient satisfaction survey conducted within the outpatient setting had a 79% positive feedback pertaining to the use of this new technology.
Conclusions: The use of an electronic diabetes data management system and routine downloading of all blood glucometers and insulin pumps in clinics can help provide a high quality service for children and young people who require treatment, education and advice for the management of type 1 diabetes. This initiative showed effective use of technology in achieving significant clinical improvements in glycaemic control and patient satisfaction.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology