Jenny Lind diabetes care better than national average
A national audit of children with diabetes has revealed the Jenny Lind diabetes team at the Norfolk and Norwich University Hospital is achieving among the best results in the country.
The National Diabetes Audit undertook an analysis of 2009/10 data from the 155 paediatric units across England and Wales. A total of 271 children with Type 1 Diabetes were included in the Jenny Lind audit return for 2009/10.
Type 1 diabetes means the child's pancreas stops producing insulin and makes blood sugar levels difficult to control. The children need multiple daily injections of insulin and 4 or more finger prick tests to manage their condition.
One of the key measure of diabetes control is a blood test called HbA1c – this measures how much glucose is attached to blood cells over a period of time, and lower the HbA1c the better the control and less the risk of diabetes related long term complications.
- An HbA1c value of less than 7.5% is lowest risk glucose control
- An HbA1c value of 7.5% to 9.5% is increased risk glucose control
- An HbA1c value of more than 9.5% is highest risk glucose control
And the results for the latest audit of HbA1c show that patients at the Jenny Lind achieved lower HbA1c results compared to the national average. The median HbA1c for Jenny Lind children was 8.5% and the median for all units was 8.8%. There are more children in the lowest risk group in Jenny Lind clinic compared to rest of the country.
- More Jenny Lind children had an HbA1C value of less than 6.5% than the national average
- More Jenny Lind children had an HbA1c value of less then 7.5% than the national average
- More Jenny Lind children had an HbA1c value in the range 7.5-8.5% than the national average
- Fewer Jenny Lind children had an HbA1c value in the range 8.5-9.5% than the national average
- Fewer Jenny Lind children had an HbA1c value in the range 9.5-10.5% than the national average
- Fewer Jenny Lind children has an HbA1c value greater than 10.5% than the national average
The National Diabetes Audit also shows that children with Type 1 diabetes under the care of the Jenny Lind team were more likely to have had their HbA1c measured every year (98.5% compared to a national average of 97%).
The national audit also looks at the incidence of diabetic ketoacidosis (DKA). Diabetic ketoacidosis happens when consistently high blood glucose leads to the production of ketones which make the blood more acidic. DKA is a potentially serious complication of diabetes and can make children unwell very quickly. DKA can be prevented by appropriate self management and should be rare after a patient is first diagnosed.
Over a one year period the incidence of ketoacidosis among children under the care of the Jenny Lind team was 10.3 per 100 patients compared to 13.8 per 100 patients nationally.
The paediatric diabetes team at NNUH is comprised of consultant paediatricians Dr Vipan Datta, Dr Nandu Thalange, specialist nurses Gill Ward, Jo Gibbons, Jane Clarke, Faye Stubbs and dietician Lucy Findlay. The team has recently been joined by Dr Jo Derisley (clinical psychologist) and Alison Coad (cognitive behaviour therapist).
There are about 350 children under the age of 18 years from Norfolk and Suffolk with Type 1 diabetes who attend the Jenny Lind diabetes service at Norfolk and Norwich University Hospital. The children’s team is complemented by Dr Swe Myint and Dr Tara Wallace who provide the seamless transition of diabetes care from age of 17 onwards at the Elsie Bertram Diabetes Centre.
Dr Datta said: “Looking after children with diabetes is a huge challenge and we do our best for them. We are fortunate in being able to take advantage of modern technology to manage diabetes, we also have the generous help of local voluntary and parent groups who provide us with medicalert jewellery, information, books and adventure breaks for children with diabetes.
As a team we always aim to improve and learn from our families, many of whom are experiencing rapid social changes. Juggling their many commitments and raising children with diabetes, they still find time to fund raise, support each other and meet with us in clinics. Keeping abreast of the times we are continuing to work with local community groups.
Our aim is to keep children with diabetes out of hospital and able to manage their own diabetes. We regard ourselves as a team to keep them well.”