Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Audit on the management and clinical outcome of patients treated in the Joint Diabetic-Renal Clinic (JDRC) at the Royal Darwin Hospital (RDH), Northern Territory (#369)

Ni Ni Khin 1 , William Majoni 2 , Louise Ciin 1
  1. Department of Endocrinology, Royal Darwin Hospital, Darwin, 0810, NT, Australia
  2. Department of Nephrology, Royal Darwin Hospital, Darwin, NT, 0810, Australia

Aim: To assess the management and clinical outcome of patients treated in the Joint Diabetic-Renal Clinic (JDRC) at Royal Darwin Hospital.
Methods: A retrospective audit was performed between 1 January 2012 and 31 March 2013. Data on clinic attendances, clinical and biochemical markers were collected from patient’s records and electronic Health records.
Results: Total 40 patients were studied, 20 were men and 20 women. Median age was 55 (27-81) years. Ten (25%) were Indigenous. 36 had type 2 diabetes, three had type 1 and one had steroid induced diabetes

Of 40 patients, 31 were included after exclusion criteria. 13 out of 31 patients attended JDRC only once for various reasons and 18 patients attended twice or more during study periods. Among 18 patients, five were on haemodialysis and three received renal transplant. 8/18 (44%) had Ischemic Heart Disease, 2/18 had Peripheral Vascular Disease. 14/18 (77%) were on lipid lowering agents. ACEI / angiotensin receptor blocker were used in all patients except those on haemodialysis.

Median HbA1c at baseline was 8.6% (5.9 -12.6%) among 18 patients who were followed up more than once at JDRC. After 6-12 months follow-up, eight out of 18 (44.4%) had improved glycaemic control, 5/18 (27.7 %) had stable HbA1c and 5 had worsened HbA1c. Median HbA1c was 7.5% (6.4-11%) at follow up. After excluding five haemodialysis patients and three transplant patients, four out of nine (44%) had stable renal function, 2/9 (22%) had improved albuminuria and 3/9 (33%) had worsened renal function. After censoring 5 dialysis patients, 4 out of 13 patients had better blood pressure (BP) control, 6 had stable and 3 had worsened BP.

Conclusion: Our results revealed that the JRDC has positive impacts in obtaining better metabolic control and delaying renal progression, with potential reduction on cardiovascular morbidity, mortality and premature death in the longer term.