Dr. Faheem Akhtar Dr. Neemisha Jain

 To look at the HbA1c profile in the short, medium and long term after starting CSII  To perform sub group analysis of HbA1c profile in different age groups ( 0 to 7yrs, 7 – 12 yrs, 12 – 15 yrs. and 15 +years)  To compare the HbA1C profile when indication for CSII was Lifestyle choice or medical

 Retrospective single centre audit  Involved both Surrey and Sussex patients  Included all children on CSII as of Dec 2013  Pt. identified from diabetes database  Review of diabetic nurses notes, Dictate it letters & Medical notes  Data collection on proforma and excel sheet

 Total no of Children with T1DM 182  Total children with T1DM on CSII = 69 (38%) (Including children in transition care, age up to 19yrs)  8 Transition clinic children Excluded - because unable to collect relevant data  N= 61 Children included in audit analysis

 Collected the Average HbA1c for the following period blocks 1) One year prior to starting CSII 2) After starting CSII 0 to 6 months  6 to 12 months  1 to 2 years  2 to 3 years  3 to 4 years  more than 4 years

26 = Choice

29 = Medical

11 = Both

Average Hb1AC - Before commencement, within 6 months to Jan 2014

33 Male – 9 choice; 18 medical; 5 both choice and medical; 1 x unk

36 Female – 17 choice; 11 medical; 6 both choice and medical; 2 x unk

 Average improvement in HbA1c from 8.9 to 8.2% in first 1 year.  Significant improvement seen in the short term across all the groups  Improvement in HbA1c is most marked when CSII is started for medical reasons  Those Who opted for CSII as lifestyle choice had better HbA1C before the start and continued to do better

 Teenagers also showed an improved HbA1C but not as marked as other groups

 Sara Cuming, Audit Dept  Chandan Yaliwal, Consultant Paediatrician