Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2016

An Audit of the Cardio-Metabolic risk profile of adults attending a tertiary referral hospital Diabetes Clinic in South Western Sydney. (#282)

Sarah N Parry 1 , Lili Yuen 1 2 , Namson S Lau 1 2
  1. Department of Diabetes and Endocrinology, Liverpool Hospital, Liverpool, NSW, Australia
  2. LIVE DIAB, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia

Background: Diabetes is the fastest growing chronic condition globally and in Australia. Latest estimates are that 1 in 11 adults have diabetes, including ~1.7 million Australians. It is associated with increased cardio-metabolic complications and reduced life expectancy. Liverpool Hospital, the leading tertiary referral hospital in South West Sydney, services close to 1 million people; among those ~11% have diabetes. An audit of people attending this hospital’s Outpatient Diabetes Clinic (ODC) was conducted to assess their cardio-metabolic profile and review opportunities to identify and optimize control of risk factors, enhance patient care and reduce morbidity and mortality.

Methods: People with diabetes attending the ODC were surveyed during their routine visits. Each patient provided information regarding demographics, history of diabetes, other cardio-metabolic risk factors, diabetes complications and current management. Blood pressure was measured and blood (HbA1C, fasting lipids, renal function) and urine (albumin to creatinine ratio) tests performed.

Results: Fifty-nine people were audited (47% male, 53% female). The “average” patient was female, aged 59, with type 2 diabetes diagnosed more than 10 years ago. She had hypertension (127/75 ± 18/7) and hyperlipidaemia (4.1±1.1) on medical therapy and ~1.7 complications from diabetes (36% CKD, 36% PN). HbA1c was above-target (7.7%) despite both oral hypoglycaemics and insulin. Her absolute 5-year risk for cardiovascular disease (Australian Absolute CVD Risk calculator) at 7% was considered low-moderate risk. However a sub-analysis showed >60% had ≥1 condition that automatically placed them into the highest 5-year at risk category (>15%). Full details of audit will be shown.

Conclusion: Whilst this audit showed that the “average” patient attending this clinic had low – moderate risk of CVD, a significant proportion were in the highest at-risk category. Attendance is an opportunity to identify these people and optimize control of modifiable factors to reduce their elevated CVD risk.