BACKGROUND AND AIMS The aims were to assess the multidisciplinary resources allocated to different paediatric departments treating diabetes in Norway and the relationship to key clinical outcome data. In 2007 The Norwegian Diabetes Association (NDA) recommended diabetes team resources per 100 children: one fulltime diabetes nurse educator, one fulltime consultant, one half-time dietician, psychologist in 40 % position and social worker in 20 % position. In this study, this recommendation is defined as a full multidisciplinary team. SUBJECTS AND METHODS Norway has a national surveillance childhood diabetes registry. Each year all patients perform a systematic examination according to WHO Basic Information Sheet. In 2007, 1853 patients from all 26 paediatric departments participated, comprising more then 85 % of all patients in the country (fig.1). HbA1c was measured in one central laboratory for all the patients. In a special entry sheet this data were registered: 1. Number of different professions in each diabetes team 2. How the team was organized 3. Number of children treated A systematic, nationwide study of diabetes team resources in paediatric departments. A general nationwide deficit in resources was detected. 11/26 departments treated > 100 children with diabetes. Only 36% (4 / 11) of these hospitals had a multidisciplinary diabetes team. 15/26 departments treated < 100 children with diabetes. 53% (8/15) of these hospitals had a diabetes team. (fig.2). A great variation in staffing was detected among the 26 hospitals. 4 (15%) departments had no dietician, 11 (42%) had no psychologist, 7 (27%) had no social worker. Only 12/26 (46%) of the departments had a multidisciplinary diabetes team according to the recommendation by NDA. Mean HbA1c from all hospitals was 8,4% (hospitals range 7,8- 8,9). Only 33 % of the patients reach the HbA1c target of 7,5 %. However, no significant difference in HbA1c was found whether the centres had a defined diabetes team or not. RESULTS 1 Oslo University Hospital, Dept. of Paediatrics, Ullevål, Norway 2 Oslo Diabetes Research Centre, Oslo, Norway 3 Center for Clinical Research, Ullevål University Hospital, 4 University of Oslo, Faculty of medicin, Oslo, Norway Address for correspondence: [email protected] CONCLUSION Less than half of the paediatric departments had a multidisciplinary diabetes team as recommended by the Norwegian diabetes Association. Lack of resources may contribute to that only one third of the patients reach treatment goals of blood glucose control. Kummernes, S.J. 1, , Skrivarhaug, T. 1,2, , Brunborg, C. 3, , Margeirsdottir, H.D. 2,4, , Dahl-Jørgensen, K. 1,2,4, The Norwegian Childhood Diabetes Registry Fig.1. Number of patients with type 1 diabetes in the paediatric dept. in Norway. Fig.2. Percentage of hospitals which have a multidisiplinary team according to the DNA`s recommendation. Percentage of hospitals with < 100 patients according to NDF recommendation. 53 % 47 % Yes No Percentage of hospitals with > 100 patients according to NDF recommendation. 36% 64% Yes No 0 20 40 60 80 100 120 140 160 180 200 220 240 Haukland Universitets sykeh Ullevålsykehus Stavanger sykehus A -hus StO lavs Hospital Fredrikstad sykehus Kr.sand sykehus Telem ark sykehus Dram m en sykehus Nordlandsykehuset,Bodø Elverum sykehus Tønsberg sykehus Haugesund sykehus Ålesund sjukehus Lilleham m er sykehus Arendalsykehus Rikshospitalet Førde sykehus Trom sø sykehus Kr.sund sykehus Levanger sykehus Hønefoss sykehus G jøvik sykehus Ham m erfestsykehus M olde sykehus Nam sos sykehus

BACKGROUND AND AIMS

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A systematic, nationwide study of diabetes team resources in paediatric departments. Kummernes, S.J. 1, , Skrivarhaug, T. 1,2, , Brunborg, C. 3, , Margeirsdottir, H.D. 2,4, , Dahl-Jørgensen, K. 1,2,4, The Norwegian Childhood Diabetes Registry. - PowerPoint PPT Presentation

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BACKGROUND AND AIMS

The aims were to assess the multidisciplinary resources allocated to different paediatric departments treating diabetes in Norway and the relationship to key clinical outcome data. In 2007 The Norwegian Diabetes Association (NDA) recommended diabetes team resources per 100 children: one fulltime diabetes nurse educator, one fulltime consultant, one half-time dietician, psychologist in 40 % position and social worker in 20 % position. In this study, this recommendation is defined as a full multidisciplinary team.

SUBJECTS AND METHODS

Norway has a national surveillance childhood diabetes registry. Each year all patients perform a systematic examination according to WHO Basic Information Sheet. In 2007, 1853 patients from all 26 paediatric departments participated, comprising more then 85 % of all patients in the country (fig.1). HbA1c was measured in one central laboratory for all the patients. In a special entry sheet this data were registered:

1. Number of different professions in each diabetes team2. How the team was organized3. Number of children treated

A systematic, nationwide study of diabetes team resourcesin paediatric departments.

A general nationwide deficit in resources was detected. 11/26 departments treated > 100 children with diabetes. Only 36% (4 / 11) of these hospitals had a multidisciplinary diabetes team. 15/26 departments treated < 100 children with diabetes. 53% (8/15) of these hospitals had a diabetes team. (fig.2).A great variation in staffing was detected among the 26 hospitals. 4 (15%) departments had no dietician, 11 (42%) had no psychologist, 7 (27%) had no social worker. Only 12/26 (46%) of the departments had a multidisciplinary diabetes team according to the recommendation by NDA. Mean HbA1c from all hospitals was 8,4% (hospitals range 7,8-8,9). Only 33 % of the patients reach the HbA1c target of 7,5 %. However, no significant difference in HbA1c was found whether the centres had a defined diabetes team or not.

RESULTS

1Oslo University Hospital, Dept. of Paediatrics, Ullevål, Norway 2Oslo Diabetes Research Centre, Oslo, Norway

3Center for Clinical Research, Ullevål University Hospital,

4University of Oslo, Faculty of medicin, Oslo, NorwayAddress for correspondence: [email protected]

CONCLUSION

Less than half of the paediatric departments had a multidisciplinary diabetes team as recommended by the Norwegian diabetes Association. Lack of resources may contribute to that only one third of the patients reach treatment goals of blood glucose

control.

Kummernes, S.J. 1,, Skrivarhaug, T. 1,2,, Brunborg, C.3,, Margeirsdottir, H.D.2,4,, Dahl-Jørgensen, K.1,2,4,

The Norwegian Childhood Diabetes Registry

Fig.1. Number of patients with type 1 diabetes in the paediatric dept. in Norway. Fig.2. Percentage of hospitals which have a multidisiplinary team according to the DNA`s recommendation.

Percentage of hospitals with < 100 patients according to NDF recommendation.

53 %

47 %Yes

Percentage of hospitals with > 100 patients according to NDF recommendation.

36 %

64 %

Yes

0 20 40 60 80 100 120 140 160 180 200 220 240

Haukland Universitets sykeh

Ullevål sykehus

Stavanger sykehus

A-hus