A clinical audit of technology use in people with type 3c diabetes at Stobhill Hospital Diabetes Clinic

Aims: Type 3c diabetes is associated with exocrine and endocrine pancreatic damage, often requiring insulin and pancreatic enzyme replacement. Access to technologies to assist optimal glycaemic management in appropriate patients is important but variable. This study aimed to assess aetiology, management and prescription of flash glucose monitoring (Freestyle Libre) and HbA1c levels in people with type 3c diabetes attending Stobhill Diabetes Clinic.

Methods: Data (2014–2023) related to 125 individuals with type 3c diabetes (74.4% male, 25.6% female), mean age 59 years (23–92 years) was extracted from SCI-Diabetes database and anonymised. Age, sex, aetiology, social deprivation index (SIMDQ) and glycaemic control (HbA1c) were evaluated against insulin and Freestyle Libre 2 prescription.

Results: Alcohol-induced disease accounted for 50.4% of cases (51 male:12 female), followed by gallstone-induced (23.2%; 18 male:11 female). Only 24.8% achieved target HbA1c <58 mmol/mol, while 37.6% had HbA1c >75 mmol/mol. Insulin was prescribed to 94.4% (n = 118), with 34.7% (n = 41) also using Freestyle Libre 2. Only 9.8% of Freestyle Libre users had an HbA1c <58 mmol/mol, while 48.8% had HbA1c >75 mmol/mol. Regarding social deprivation (SIMDQ), 51.2% were from the lowest quintile and 20.8% from the second lowest quintile.

Conclusion: The majority of people with type 3c diabetes required insulin, had an HbA1c >75 mmol/mol and were from the 1st SIMDQ quintile with an only minority having access to Freestyle Libre. This study highlights inequity of access to technologies that requires to be addressed. Further research is essential to better understand how to meet the needs of people with type 3c diabetes.