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

Insulin pump therapy practices in young adults with type 1 diabetes in a tertiary hospital young adults transition clinic (#237)

Thora Y Chai 1 , Kaye Farrell 2 , Jane Holmes-Walker 1 2 3
  1. Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW, Australia
  2. Diabetes Transition Support Program, Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW, Australia
  3. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

Introduction: Transition from paediatric to adult diabetes care is a high-risk period, when glycaemic control may deteriorate due to maturational changes that adversely impact self-care behaviours in young adults with type 1 diabetes (T1DM). With a growing proportion on insulin pump therapy (IPT), regular attendance at a young adult diabetes transition clinic (YAC) is important to optimise IPT practices and improve glycaemic control. We hypothesised those aged ≥22 years (yrs) have better IPT practices than those aged <22yrs, secondary to an increased ability to perceive the consequences of non-adherence.

Objective: To compare glycaemic control and IPT practices in younger individuals (<22yrs) with older individuals (22-27yrs) attending a YAC.

Methods: IPT records (Diasend and Medtronic) were prospectively downloaded from 98 young adults with T1DM presenting to a tertiary hospital YAC from August 2015 – February 2016. Diabetes duration, clinic visits/yr, initial and follow-up HbA1c were obtained from the clinic database. IPT data between age groups were compared with Mann-Whitney U test. The relationship between follow-up HbA1c, clinic attendance, total and food correction bolus/day were analysed with Spearman’s rank correlation.

Results: Fifty-four IPT patients were <22yrs and 44 were ≥22yrs, representing 80% of all IPT patients attending the YAC. Thirty percent of patients were not on IPT at transition. Table 1 summarises findings and shows no significant difference in either group in initial or follow-up HbA1c, clinic visits/yr or mean blood glucose. Increased number of insulin correction and food correction bolus/day was associated with lower HbA1c. There was no relationship between HbA1c and clinic attendance (Table 2).  


Conclusion: Regardless of age, young adults with T1DM on IPT who attended a YAC maintain stable clinic attendance and IPT practices. In contrast to previous publications, maturity did not alter diabetes self-care behaviours and may require comparison with >27yrs to detect improvement in glycaemic control.