In order to improve type 1 diabetes care, diabetes healthcare providers first must ensure that patients make it to clinic for regular appointments. That may not be as easy as it sounds, as data suggests that many people with type 1 diabetes are going longer than recommended by some guidelines between appointments.
In an abstract accepted at the American Diabetes Association (ADA) 79th Scientific Sessions, clinicians with the T1D Exchange Quality Improvement Collaborative revealed that most young patients with type 1 diabetes struggled to fit in four clinic visits a year with their diabetes healthcare providers. In addition, the length of time between visits grew with the age of the patients studied.
Six pediatric diabetes clinics reported depersonalized data of clinic visit frequency for 31,358 patients, aged 0 to 26 years old. Researchers then excluded data from newly diagnosed patients for the study, and segmented the patients by age. The target amount of time for the study was 90 days between visits, but all groups of patient averaged longer than that.
Here is the average number of days between visits by age group:
0 years old to 6 years old – 101.7 days
7 years old to 12 years old – 110.2 days
13 years old to 17 years old – 118.8 days
18 years old to 26 years old – 135.4 days
The International Society of Pediatric and Adolescent Diabetes recommends outpatient clinic visits every three months for people with type 1 diabetes. The ADA recommendations are a bit more flexible – every three to six months.
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In the abstract, the clinicians do not suggest why patients are spacing out their visits. In online forums, however, many people in the type 1 diabetes communities often discuss difficulties with scheduling clinic appointments, citing such reasons as overbooked clinicians, transportation issues, dissatisfaction with care received, and cost. In a recent informal T1D Exchange Glu Question of the Day poll, for example, 38.6 percent of respondents said they spaced out visits because of costs.
The Collaborative has been establishing baseline data of its network of clinics. In the next phase of the Collaborative’s work, clinicians have committed to experimenting with making small changes to improve care and then studying patient outcomes as a result. It will be interesting to see if such changes shorten the average number of days between visits over time.
To learn more about the Collaborative, click here.
You can read more about T1D Exchange-related research at the ADA 79th Scientific Sessions here.