ESPE Abstracts

Background: In August 2022, the National Institute of Health and Care Excellence recommended that all adults and children with type 1 diabetes (T1DM) should have access to Continuous Glucose monitoring systems (CGM). This guidance will increase the number of T1DM patients who present in the A&E department and the use the new diabetes technologies in clinical practice. In addition, hybrid closed-loop (HCL) systems which integrate CGM and insulin pumps to automate insulin delivery are also being increasingly used.

Aim: We undertook a single-center qualitative study to explore the knowledge, attitudes, and perceptions of A&E doctors around the new diabetes technologies such as CGM, pumps and hybrid-closed loop systems in order to identify specific areas that could be improved.

Methods: We conducted semi-structured interviews with 16 doctors working in A&E department. The interviews were recorded and transcribed and thematic analysis methodology was used to analyse the data.

Results: The vast majority of doctors (87.5 %, 14/16) had encountered T1DM patients with either a CGM, pump or and HCL system. 87.5% described their knowledge around them as insufficient, and 94% (15/16) rated their confidence as extremely low. Other common emotions around the new technologies were fear and anxiety (Table 1). All doctors (16/16) stated that further training around new diabetes technologies would be welcomed as it would improve their confidence (68.75%,11/16) and improve patient care (87.5%, 14/16). The most common areas of interest mentioned are the need for education surrounding the principles of function of the devices, troubleshooting and how to clinically manage common patient presentations.

Conclusions: We recommend that appropriate educational training programs and modules be implemented to support A&E doctors and staff in managing T1DM patients presenting with new diabetes technologies.