Management of Type I Diabetes Mellitus at a Rural Paediatric Diabetes Clinic

IF 1.9 4区医学 Q2 NURSING

Australian Journal of Rural Health Pub Date : 2025-02-24 DOI:10.1111/ajr.70013

Kuangjun Li, Ann M. Maguire, Jacqueline Askwith

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引用次数: 0

Abstract

Objective

Australia currently lacks a standardised paediatric diabetes care model. This study explores the model of care and outcomes of paediatric Type 1 diabetes mellitus (T1D) at a rural multidisciplinary paediatric diabetes clinic.

Methods

A retrospective cross-sectional study.

Design

A single centre quantitative study.

Setting

A rural multidisciplinary paediatric diabetes clinic.

Participants

Patients under 19 years old with a T1D diagnosis who attended the paediatric diabetes clinic for at least 12 months.

Main Outcome Measures

Baseline demographics, glycosylated haemoglobin (HbA1c) levels, time in range, clinic appointment adherence, and diabetes-related hospitalisations over a 12-month period from October 2021 to September 2022.

Results

Fifty-two patients, with a median age of 13.5 (IQR 7) years and 58% females, were included. Of the patients, 40% lived more than 50 km away from the diabetes clinic, 73% were on continuous subcutaneous insulin infusion, and 92% used continuous glucose monitoring. The median HbA1c was 8.3% (67 mmol/mol), with four patients (8%) achieving the international target HbA1c level of less than 7.0% (53 mmol/mol). The CGM users' average time in range was 54%. A total of 29 patients (56%) attended all annual clinic reviews. Six patients (12%) were hospitalised for diabetes-related complications.

Conclusion

Paediatric T1D managed in a rural multidisciplinary paediatric diabetes clinic, with experienced local clinicians and support from a tertiary centre, can attain outcomes in glycaemic control, clinic attendance, and diabetes-related hospitalisation comparable to those of large Australian metropolitan clinics. However, glycaemic outcomes remain suboptimal when compared to international standards.

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农村儿童糖尿病诊所I型糖尿病的管理

目的澳大利亚目前缺乏标准化的儿科糖尿病护理模式。本研究探讨了农村多学科儿科糖尿病诊所的儿童1型糖尿病（T1D）的护理模式和结果。方法回顾性横断面研究。设计单中心定量研究。建立农村多学科儿科糖尿病门诊。参与者：在儿科糖尿病诊所就诊至少12个月的19岁以下T1D诊断患者。基线人口统计学、糖化血红蛋白（HbA1c）水平、范围时间、门诊预约依从性以及从2021年10月至2022年9月12个月期间糖尿病相关住院。结果纳入52例患者，中位年龄13.5 （IQR 7）岁，女性占58%。在这些患者中，40%的患者居住在距离糖尿病诊所50公里以上的地方，73%的患者持续接受皮下胰岛素输注，92%的患者持续接受血糖监测。中位HbA1c为8.3% (67 mmol/mol)， 4例患者（8%）达到国际目标HbA1c水平低于7.0% （53 mmol/mol）。CGM用户的平均停留时间为54%。共有29名患者（56%）参加了所有年度临床回顾。6名患者（12%）因糖尿病相关并发症住院。结论：在农村多学科儿科糖尿病诊所，在经验丰富的当地临床医生和三级医疗中心的支持下，在血糖控制、就诊人数和糖尿病相关住院治疗方面可以达到与澳大利亚大城市诊所相当的结果。然而，与国际标准相比，血糖结果仍然不理想。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

2.30

自引率

16.70%

发文量

122

审稿时长

12 months

期刊介绍： The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.