Young patients with diabetes are particularly vulnerable to long‐term complications, and require a carefully planned transition to adult diabetes care. As clinic non‐attendance has been identified as an issue for transitional clinics, we audited our well established clinic to look at non‐attendance rates, and to examine the characteristics of those who miss transitional clinic appointments.We conducted a retrospective analysis of audit data from the diabetes transitional clinic in January to December 2004, and September 2007 to September 2008.The results showed that 40/53 patients missed at least one appointment in 2004, compared to 19/61 in 2007–8 (p<0.0001). There was no reduction in HbA1c in this group (2004: median HbA1c 9.4% [range 6.8–13.2%]; 2007–8: median HbA1c 9.7% [range 5.7–14.0%[). In 2007–8, the non‐attender group had higher HbA1c (full attenders: median [range] HbA1c 8.9% [5.7–12.7%]; those who missed at least one appointment: HbA1c 10.3% [7.7–14.0%]; p<0.001), and were older (non‐attenders mean [SD] 18.0 [1.10] years, full attenders 17.3 [1.17] years). Sex and type of diabetes did not affect ‘did not attend’ rates.Those who miss diabetes transitional clinic appointments have poorer glycaemic control, although non‐attendance is complex and may be due to a variety of reasons. New strategies to help young people deal with their diabetes are needed. Copyright © 2010 John Wiley & Sons.

Multipractice audit is widely used and can affect diabetes care. We reviewed the Dorset diabetes audit between 1996 and 2001 to investigate the prevalence of diabetes and to examine if the processes of diabetes care change over time.Data on prevalence of diabetes and the numbers of patients who underwent annual diabetes review, foot and eye screening, and measurement of blood pressure (BP), creatinine and HbA 1c was obtained from 102 out of 109 Dorset general practices (involving a total population of 663 466 people) on an annual basis between 1996 and 2001. The prevalence of diabetes in Dorset rose significantly between 1996 and 2001, adversely affecting diabetes complication screening rates. Screening rates for diabetes complications deteriorated over the five years of our study, after an initial rise when the audit was newly established. Alternative strategies to improve diabetes care may be necessary to change clinical practice.

Self‐management of type 1 diabetes (T1DM) can be undermined by anxiety about life events; consequently, we introduced a counselling service for people with T1DM (using Person Centred Integrative Counselling) to address their concerns and anxieties about their condition, and this involved a six‐week course of 50‐minute sessions with a qualified and experienced counsellor. We have evaluated the counselling service, looking for benefits for the participants. We undertook a retrospective analysis of data obtained for people referred to the service between June 2007 and June 2010, pre‐ and post‐attendance at the course of counselling. Outcomes were HbA1c as a measure of glycaemic control, and scores from the Clinical Outcomes in Routine Evaluation (CORE) questionnaire (a measure of feelings of anxiety and risk) to assess the effectiveness of the counselling. Of 79 people referred, 62 completed the course. There was no difference between those who did or did not complete in terms of demographic data, pre‐counselling HbA1c or pre‐counselling CORE score. Of those who completed the course, there were reductions in HbA1c (pre‐counselling [median (range)] 9.5% [6.2, 17.8], post‐counselling 9.3% [5.9, 11.4]; p=0.007) and CORE score (pre‐counselling [mean ± SD] 1.60±0.71, post‐counselling 0.89±0.57; p<0.001). Completion of a course of counselling sessions was associated with improvements in glycaemic control and reduction in anxiety and risk about T1DM. This may be an effective intervention in helping patients with T1DM to self‐manage their condition. Copyright © 2011 John Wiley & Sons.