Prospective observational study of referrals to hospital diabetes specialist care team (2004–2008) at a tertiary care centre

Abstract

Aims Diabetes inpatient specialist teams (DISTs) support other departments to care for people with diabetes. The aim of this study was to evaluate the role of our adult DIST to ascertain the types of patients referred, reasons for referrals and the frequency of referrals. Methods Using prospectively collected data on our adult DIST activity (patients > 14 yrs), we retrospectively analysed all referrals over a 48-month period (October 2004–October 2008). We also performed a more focused study over a two-month period obtaining more detailed information on DIST–patient interaction. Results Over the 48 months of the study, more referrals were from medical (1879, 66%) than from surgical specialties (641, 23%). Most medical referrals were from the acute medical admissions unit (411, 14.4%); the most common referral being hyperglycaemia (339, 15%). Inpatient review was the most frequent task undertaken (76% of DIST–patient interactions), which included optimisation of medication and re-review, and 15% of reviews occurred at weekends. Following an education strategy for nursing staff, referrals for hypoglycaemia decreased (27.4% in 2005, 14.7% in 2008, p=0.04 for trend). Conclusion A DIST makes important contributions to diabetes care in all major hospital departments. Evaluating referral patterns can help identify educational needs.