6648 Audit of university hospitals Birmingham ‘High HbA1c pathway’ for children and young people with type 1 diabetes mellitus

Objectives The National Institute for Health and Care Excellence recommends maintaining HbA1c 1 Yet, the national average HbA1c in this group is significantly worse, at 64mmol/mol (8%).2 The University Hospitals Birmingham (UHB) 'high HbA1c pathway' aims to lower and maintain HbA1c 8.5%. Spanning 3 months, the pathway involves five appointments, commencing with a nurse-led review, followed by three nurse-led telephone appointments, and concluding with a multi-disciplinary team review. We conducted an audit of the UHB high HbA1c pathway to assess the following: Is the UHB high HbA1c pathway being followed correctly? Is the UHB high HbA1c pathway effectively lowering patients' HbA1c? Methods The audit was set in UHB Paediatric Diabetes Department. Dendrite electronic health records for all CYP with T1DM initiated on the UHB high HbA1c pathway between April 2022 and September 2022 were retrospectively reviewed. Data on patient demographics, attendance rates, and HbA1c measurements were collected. Subsequent quantitative data analysis was conducted using Microsoft Excel. Results 35 CYP were initiated on the pathway between April 2022 and September 2022. Conclusion All CYP initiated on the UHB high HbA1c pathway had a lower HbA1c upon pathway completion. However, only 31% of CYP achieved the target HbA1c of References National Institute for Health and Care Excellence. Diabetes (type 1 and type 2) in children and young people: diagnosis and management. NICEguidelines NG18 internet. London: National Institute for Health and Care Excellence; 2015/2022 cited 2022 Oct 21. Available from: https://www.nice.org.uk/guidance/ng18 RCPCH State of Child Health. Diabetes internet. 2020 cited 2022 Oct 26. Available from: https://stateofchildhealth.rcpch.ac.uk/evidence/long-term-conditions/diabetes/