Non-attendance at a diabetes transitional clinic and glycaemic control

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Young patients with diabetes are particularly vulnerable to long-term complications, and require a carefully planned transition to adult diabetes care. As clinic non-attendance has been identified as an issue for transitional clinics, we audited our well established clinic to look at non-attendance rates, and to examine the characteristics of those who miss transitional clinic appointments.We conducted a retrospective analysis of audit data from the diabetes transitional clinic in January to December 2004, and September 2007 to September 2008.The results showed that 40/53 patients missed at least one appointment in 2004, compared to 19/61 in 2007-8 (p<0.0001). There was no reduction in HbA1c in this group (2004: median HbA1c 9.4% [range 6.8-13.2%]; 2007-8: median HbA1c 9.7% [range 5.7-14.0%[). In 2007-8, the non-attender group had higher HbA1c (full attenders: median [range] HbA1c 8.9% [5.7-12.7%]; those who missed at least one appointment: HbA1c 10.3% [7.7-14.0%]; p<0.001), and were older (non-attenders mean [SD] 18.0 [1.10] years, full attenders 17.3 [1.17] years). Sex and type of diabetes did not affect ‘did not attend’ rates.Those who miss diabetes transitional clinic appointments have poorer glycaemic control, although non-attendance is complex and may be due to a variety of reasons. New strategies to help young people deal with their diabetes are needed. Copyright © 2010 John Wiley & Sons.

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