HbA1c and other cardiovascular risk factors: outcomes in a tertiary multidisciplinary Young Adults Diabetes Service — ASN Events

HbA1c and other cardiovascular risk factors: outcomes in a tertiary multidisciplinary Young Adults Diabetes Service (#233)

Annie Hung 1 , Frances Harley 1 , Janet Rahman 1 , Tricia Wong 1 , Bala Murthy 1 , Emily Karahalios 1 , Christine Rodda 1
  1. Western Health, Melbourne, Victoria, Australia

Childhood-onset Type 1 Diabetes Mellitus (T1DM) is associated with a high risk of developing long-term microvascular and macrovascular complications, the pathogenesis of which occurs throughout puberty and is highly correlated with glycaemic control. However, monitoring of cardiovascular risk factors over and above glycaemic control is frequently overlooked in young adults. Our aim was to assess the prevalence of cardiovascular risk factors and the changes to HbA1c in young people with T1DM aged 15- 25 attending a Young Adults Diabetes Service (YADS) in a tertiary outer metropolitan setting.  An audit was undertaken to obtain data including age and gender, HbA1c, duration of T1DM, blood pressure, smoking status, BMI and lipid profile from medical records. Mean and standard deviation or median and inter-quartile range, depending on data distribution, were used. Of the 64 eligible participants assessed from February to June 2015, 78% had one or more cardiovascular risks factors and 39 paticipants (65%) had an HbA1c above the standard of 7.5% currently recommended by NH&MRC guidelines (2011). Our audit showed that to date around a quarter of those aged 15 – 25 years with T1DM within our catchment, have been referred to this clinic, and of these, only 60/123 (49%) attended at least one YADS appointment. Engagement of this vulnerable age group in a developmentally appropriate medical setting is crucial albeit challenging. We recommend a consistent multidisciplinary approach across community general practice and tertiary hospital settings with agreed, shared therapeutic targets to improve the future cardiovascular health of all young adults with T1DM.

  1. Marcovecchio et al. Adolescent type 1 Diabetes cardio-renal Intervention Trial Research G. Adolescent type 1 Diabetes (AdDIT). BMC pediatrics. 2009;9:79.
  2. Craig et al. National Evidence-Based Clinical Care Guidelines for T1DM in Children, Adolescents and Adults. Australian Gov Department of Health and Ageing.2011;Canberra.
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