Using Technology to Reduce Recurrent Admissions for Diabetic Ketoacidosis

There have been progressively increasing rates of diabetic ketoacidosis (DKA) and hospitalisation in patients with type 1 diabetes (T1DM) over the last couple of decades. This is associated with increased mortality and a worsening burden on patients and health systems. Studies on patients with T1DM and frequent admissions with DKA are limited, however, risk factors such as lower socioeconomic status, mental health issues, and poorer blood glycaemic control have been shown to increase the risk for recurrent presentation with DKA. Given the advent of promising technology to aid with T1DM management which has so far already shown good benefits in patients with reasonably managed diabetes, and the recent expansion of Continuous Glucose Monitoring (CGM) subsidy to every individual with type 1 diabetes, exploring the role and benefit of CGM in reducing hospitalisation for patients with frequent admissions for DKA is of key importance. In phase 1 of this study, we identified the individuals with type 1 DM and frequent admissions with DKA across Monash Health. In phase 2, we aim to investigate the current use of glucose monitoring devices in the patients we identified in phase 1, via phone/telehealth review. In phase 3, we plan to co-design a new model of care including behavioural interventions, education and access to devices for this group, in order to improve glycaemic management and reduce admissions for DKA. A health economic assessment will be the final phase of this project.