P181 Diabetes nurse specialist–led glucose balance telephone support clinic associated with improved HbA1c

Published Date: 23rd March 2022

Publication Authors: Cairns J, Pendlebury H, Sullivan H, Lee C, Furlong NJ

Aims
Foot ulceration is a major burden for patients with diabetes, with a lifetime risk of up to 34%, and precedes most amputations. Hyperglycaemia is associated adverse outcomes and improving glycaemic control is key. We report the effect of diabetes specialist nurse (DSN) - led telephone support on glycaemic balance in insulin–treated patients attending a multidisciplinary outpatient foot clinic.

Methods
Data were collected retrospectively from medical records using the Trust’s electronic document management system (EDMS) using a dedicated proforma. All patients attending the telephone clinic between 01/03/2020 - 31/08/2020 were included. Data collected included HbA1c, treatment regimen, treatment interventions, attendance and clinic outcomes. Data were analysed using Microsoft Excel.

Results
Sixty patients were identified during the audit period; mean age 60 years, 43 (72%) male and 48 (80%) type 2 diabetes, mean ( ± SD) baseline HbA1c 86 ± 22.5. Insulin regimen; basal-bolus (n = 29), twice-daily insulin mixture (n = 27), basal insulin with oral hypoglycaemic agents (n = 4). A total of 256 telephone calls were made, typically 1 – 4 per patient (range 1 – 12), of which 202 (79%) resulted in successful patient contact. Of the successful contacts, 45 (22%) confirmed satisfactory glucose results, 109 (54%) required treatment adjustment and 48 (24%) had insufficient glucose data to inform treatment change. Over the audit period mean HbA1c improved by 10mmol/mol (P = 0.001).

Conclusion
DSN delivered telephone support is associated with clinically significant improvements in HbA1c but clear communication regarding appointments and glucose monitoring is essential to optimise patient contact and diabetes management.

Cairns, JA; Lee, C; Pendlebury, H; Sullivan, H; Furlong, NJ. (2022). P181 Diabetes nurse specialist–led glucose balance telephone support clinic associated with improved HbA1c in insulin-treated patients with diabetic foot ulceration. Diabetic Medicine. 39 (Supp 1), p101

 

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