Young adults with Type 1 diabetes in tertiary education: do students receive adequate specialist care?

Abstract

To examine the clinical characteristics of, and diabetes management provided for, young people with Type 1 diabetes in tertiary education. The medical case records of a group of 55 students aged 18-24 years, all of whom had Type 1 diabetes and had been referred to a hospital diabetes clinic, were examined. A mean (SD) attendance of 80% (28%) was observed for all clinic appointments. Despite greater use of intensified insulin therapy (increasing from 37% to 83%) of students neither mean HbA1c nor mean body mass index changed significantly. Microvascular complications were infrequent. Documentation in the case notes of the frequency of home blood glucose monitoring was inadequate in 25% of patients as was the recorded frequency of mild (self-treated) hypoglycaemia in (20%) of patients. Despite a satisfactory frequency of clinic attendance and organisation of insulin regimens by medical staff, glycaemic control remained unchanged throughout University attendance. The inadequate documentation of dietary habits, frequency of home blood glucose monitoring, hypoglycaemia, social habits and activities in both groups may provide a partial explanation, as other variables were not addressed. Young adults with Type 1 diabetes may benefit from receiving specialist care in a clinic dedicated to their particular needs.