Demographics, management and outcomes of inpatients with newly diagnosed diabetes in acute covid-19 infection

Aim: To evaluate service delivery during covid-19 pandemic by Paediatric Diabetes Unit. Methods: • Review of multidisciplinary team (MDT) clinic provision from 1 April 2020 to 31 December 2020. • Compare Did Not Attend(DNA) rate during pandemic with the 9 months period prior (1 July 2019 to 31 March 2020) • Evaluate use of technology for review of data from pumps/ meters/Apps. • Compare diabetes ketoacidosis (DKA) rates in newly diagnosed patients during pandemic with previous 9 months. • Feedback from families and service users (SurveyMonkey) on clinics. • Innovations/new practices. Results: • All clinics for 245 Children and Young Person with Diabetes (CYPD) were MDT (diabetes consultant, specialist nurse, dietitian, when possible psychologist) and changed to video(majority) or telephonic. • 655 MDT appointments offered during pandemic compared to 614 in the 9 months period prior. • DNA rate 5.34% (35 MDT appointments out of 655) versus 7.81% (48/614) in the previous 9-month. Dietitic 1:1 appointments DNA rate reduced from 13.5% to 3%. • Use of Diasend, Dexcom Clarity and LibreView for review of glycaemic control, estimated HbA1c, time in range. Use of reports from Apps. Use of screen share facility during video consultation to review data with family. • Newly diagnosed CYPD in DKA were higher during pandemic 46% versus 18.7% (6/13 vs. 3/16). • 90% CYPD and their families were satisfied with the remote clinics (35/39 responses). • Innovation:Drive through HbA1c, majority families downloading from home and HbA1c home-testing kits. Virtual self-care education, pump starts, carbohydrate counting training and psychology sessions. Conclusions: Continuity of service maintained and refined with use of technology/innovations. Lower DNA rates as clinics virtual. Higher DKA at presentation probably due to delay in seeking medical care. High user satisfaction. Learning from this can be used to shape future service.