Comprehensive care programme for young adults with IDDM

In 1985 St Vincent's Hospital, Melbourne developed a diabetes service tailored to the special needs of young adults in the 18‐35 year age range with insulin‐dependent diabetes. The service comprises a weekly outpatient clinic, social‐educative evening meetings and a telephone/drop‐in service. The three aspects of the scheme are inter‐related, have common goals and are serviced by the same team members (diabetes specialists, diabetes educators, dietitian and social worker). The total clinic population is 150, of these 45 are referrals from the paediatric hospital. The clinics are small (8–12) and patients see the same doctor at each visit. Analysis of clinic attendance records indicates that people keep their appointments and are more likely to telephone if unable to attend, since the inception of the scheme. Four people have not continued attendance after transfer from the paediatric hospital. Each evening meeting is attended by 30–40 people, depending on individual interest in the topic, and other personal commitments. A core group of 16 regular attenders has emerged. Individual telephone consultations average 12 patient contacts per month. Drop‐in consultations average eight patient contacts each month of > 30 minutes duration, and six contacts of < 30 minutes duration per month. There were two hospital admissions from the group who regularly attend the clinic and evening meetings compared with 12 from the non attenders.