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The British Journal of Diabetes & Vascular Disease
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The Alphabet Strategy and standards of care in young adults with type 1 diabetes

Nitin Gholap

Diabetes and Endocrinology, Leicester Royal Infirmary, LE1 5WW, UK

Meera Pillai

George Eliot Hospital, Nuneaton, CV10 7DJ, UK

Sumit Virmani

Walsgrave Hospital, Clifford Bridge Road, Coventry, CV2 2DX, UK

James D Lee

George Eliot Hospital, Nuneaton, CV10 7DJ, UK

Diane James

George Eliot Hospital, Nuneaton, CV10 7DJ, UK

John Morrissey

George Eliot Hospital, Nuneaton, CV10 7DJ, UK

Vipan Datta

Norfolk and Norwich University Hospital, Norwich, Colney Lane, Norwich, NR4 7UY, UK

Vinod Patel

Institute of Clinical Education, Warwick Medical School, The University of Warwick, Gibbet Hill Road, Coventry, West Midlands, CV4 7AL, UK, vinod.patel{at}warwick.ac.uk

The Alphabet Strategy is a mnemonic-based approach to assist commitment to important aspects of diabetes care: Advice; Blood pressure lowering; Cholesterol and creatinine control; Diabetes control; Eye examination; Foot examination; and use of Guardian drugs. This strategy reported high standards of care of patients with type 2 diabetes. This study assesses the impact of the Alphabet Strategy on diabetes management in young adults with type 1 diabetes and compared data with those of a recently published multicentre study. Results were analysed using the chi-square test and Student's t-test.

Data were collected retrospectively from 68 patients with type 1 diabetes aged 16—25 years attending the George Eliot Hospital (GEH) adolescent diabetes clinic and who were being managed as per The Alphabet Strategy.

Standards of diabetes care in the GEH clinic were better than those reported in the multicentre study. GEH versus multicentre study: clinic non-attendance 12% vs. 24.6%: mean HbA1C% 8.4 vs. 9.5, p<0.001: screening rates; hypertension 100% vs. 88%, p<0.05; nephropathy 80% vs. 56%, p<0.01; retinopathy 98% in GEH clinic: prevalence of complications; nephropathy 5% vs. 21%, p<0.02; retinopathy 24% vs. 28%, not significant.

In conclusion, we found regular clinic visits and separate adolescent clinics improve glycaemic control. The Alphabet Strategy may be considered an effective approach in monitoring/screening and attaining targets in young adults with type 1 diabetes.

Key Words: type 1 diabetes • young adults • Alphabet Strategy.

The British Journal of Diabetes & Vascular Disease, Vol. 6, No. 4, 168-170 (2006)
DOI: 10.1177/14746514060060040401
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