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Paediatric type 1 diabetes in Ireland--results of the first national audit

C P Hawkes, N P Murphy

    Irish Medical Journal
    |May 20, 2014
    PubMed

    Insights

    This study assessed pediatric type 1 diabetes care in Ireland, finding significant variations in services and insulin pump use. A national strategy is recommended to standardize care and improve outcomes for children with diabetes.

    Area of Science:

    • Pediatric Endocrinology
    • Public Health
    • Diabetes Management

    Background:

    • Type 1 diabetes (T1D) management in children requires specialized, multidisciplinary care.
    • Understanding current service provision is crucial for identifying areas for improvement in pediatric T1D care.
    • The Republic of Ireland has 19 centers providing pediatric T1D care.

    Purpose of the Study:

    • To describe current services for children with type 1 diabetes in Ireland.
    • To establish a baseline for future service and outcome improvements.
    • To identify variations in care delivery across different centers.

    Main Methods:

    • A survey was sent to lead clinicians in 17 of 19 Irish pediatric T1D centers.
    • Data collected in 2012 included demographics, patient numbers, diagnostics, management, resources, and policies.
    • Information on insulin pump therapy and glycemic control (HbA1c) was gathered.

    Main Results:

    • 17 centers responded, covering 2518 pediatric patients with T1D.
    • Insulin pump initiation occurred in 8 centers, with usage varying from 0% to 42%.
    • Mean HbA1c levels ranged from 8.2% to 9.4%, indicating suboptimal glycemic control across centers. Significant variations in guidelines, appointment frequency, transition policies, and insulin types were noted.

    Conclusions:

    • There is considerable variation in the provision of pediatric type 1 diabetes care across the Republic of Ireland.
    • Standardization of services, including insulin pump access and management protocols, is needed.
    • A national approach is recommended to improve consistency and quality of care for children with T1D.

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