outcomes-and-management-of-youth-onset-type-2-diabetes-mellitus-in-the-kimberley-a-retrospective-study

Outcomes and management of youth-onset type 2 diabetes mellitus in the Kimberley: a retrospective study


This project is part of the Kimberley Investigation and Description of type 2 Diabetes (T2DM) of Young-onset (KIDDY) study. It will describe the management and outcomes of youth (<25 years of age) with Type 2 Diabetes Mellitus (T2DM) in the Kimberley region.

It is hypothesised that there will be a significant number of young people with T2DM in the Kimberley with sub-optimal diabetes management (clinically measurable outcomes below nationally agreed targets). It is also anticipated that engagement with health services will be sporadic. Describing the current situation can help identify areas to focus resources to improve health care engagement and outcomes for young people living with diabetes in the Kimberley

Ultimately, this project will contribute to developing an agreed Kimberley model of care designed to improve outcomes for people with young-onset diabetes. This aligns with the plan for HOT NORTH to promote effective transfer of research into health policy and practice. Data from this project will contribute to the data for the HOT NORTH pilot project to describe young-onset diabetes across Northern Australia.

Background

Young-onset diabetes refers to type 2 diabetes mellitus (T2DM) that is first diagnosed at a young age.1,2 Diabetes diagnosed at less than 25 years of age will be used as the definition for this project. Young-onset T2DM is up to 20 times more prevalent amongst Aboriginal Australians, with rates increasing with remoteness.3,4 The Kimberley region of Western Australia has a large Aboriginal population and people living in remote Aboriginal communities represent a particularly high risk group for young onset T2DM.5 The rising incidence of young-onset T2DM in Aboriginal Australians will continue to significantly alter the developmental trajectory of children and adolescents in the Kimberley towards premature morbidity and mortality, due to its aggressive nature, apparent treatment difficulty, challenges in the provision of remote healthcare and difficulties engaging youth in chronic care.6-8 This project aims to describe diabetic outcomes and engagement with healthcare practitioners in youth with T2DM in the Kimberley region and to ultimately improve models of healthcare and reduce preventable complications.

Research Plan

A retrospective audit of medical records will be undertaken to identify, document and describe aspects of care for people with young-onset diabetes in the Kimberley from 2010 to 2017. Electronic health records will be used to generate a de-identified list of people meeting the inclusion criteria described below. Individuals will be allocated a study ID in the main spreadsheet, to avoid duplication across multiple sites.

Inclusion criteria:

  • <25 years old at end 31/12/2017
  • Diagnosis of T2DM or test results/ medications suggestive of a diagnosis of diabetes <25 years old
  • Have been seen at any service since 2010.

Data from this audit will be used to develop a proposed model of care for the Kimberley region. This process will involve consultation with regional primary and secondary health care services and will emphasise use of the regional skills base available. Further research seeking input from youth with T2DM may be used to further guide the development of models of care.

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