Evaluation of a secondary care multidisciplinary clinic for adults with early-onset type 2 diabetes at high risk in Leicester, Leicestershire and Rutland.
Clinical services for adults with early-onset type 2 diabetes (EOT2D) are in urgent need of improvement.
We evaluated a multi-disciplinary clinic for individuals with EOT2D at high risk (HbA1c >9%/triglyceride >20 mmol/L), providing 2-3 flexibly arranged consultations per individual between March 2024 and September 2025. Nurse-led case-finding in primary care supported identification and targeted referral of high-risk individuals. On 3 November 2025, electronic medical records were used to evaluate change in cardiometabolic outcomes at 6- and 12-months from baseline and evaluate service activity, including proportions with recorded health information and prescriptions. The paired t-test (continuous) and McNemar's test (proportions) were used to assess change in outcomes. Patient feedback was obtained using questionnaires.
In total, 159 individuals received an appointment (45% women; median age 34 years). At both 6- and 12-months post-baseline, HbA1c (at 12-months: -2.53% [95% CI: -3.13, -1.93]/-28 mmol/mol [-34, 21]), systolic (-5.89 mmHg [-9.88, -1.91]) and diastolic (-2.72 mmHg [-5.34, -0.10]) blood pressure, body mass index (BMI; -1.49 kg/m2 [-2.31, -0.67]) and weight (-3.52 kg [-6.32, -0.72]) were significantly lower. Triglycerides were lower at 12-months only (-1.12 mmol/L [-1.89, -0.34]). The proportion with BMI or smoking status recorded, and with a glucagon-like peptide-1 receptor-based treatment, was higher at 12-months than at baseline, whereas creatinine and retinal screening measurements were less frequent. A limited amount of patient feedback was positive.
Case-finding and invitation to flexibly run multidisciplinary clinics were associated with improvements in cardiometabolic outcomes and positive patient feedback. Similar services are immediately required given the rising prevalence of EOT2D and associated complications.
We evaluated a multi-disciplinary clinic for individuals with EOT2D at high risk (HbA1c >9%/triglyceride >20 mmol/L), providing 2-3 flexibly arranged consultations per individual between March 2024 and September 2025. Nurse-led case-finding in primary care supported identification and targeted referral of high-risk individuals. On 3 November 2025, electronic medical records were used to evaluate change in cardiometabolic outcomes at 6- and 12-months from baseline and evaluate service activity, including proportions with recorded health information and prescriptions. The paired t-test (continuous) and McNemar's test (proportions) were used to assess change in outcomes. Patient feedback was obtained using questionnaires.
In total, 159 individuals received an appointment (45% women; median age 34 years). At both 6- and 12-months post-baseline, HbA1c (at 12-months: -2.53% [95% CI: -3.13, -1.93]/-28 mmol/mol [-34, 21]), systolic (-5.89 mmHg [-9.88, -1.91]) and diastolic (-2.72 mmHg [-5.34, -0.10]) blood pressure, body mass index (BMI; -1.49 kg/m2 [-2.31, -0.67]) and weight (-3.52 kg [-6.32, -0.72]) were significantly lower. Triglycerides were lower at 12-months only (-1.12 mmol/L [-1.89, -0.34]). The proportion with BMI or smoking status recorded, and with a glucagon-like peptide-1 receptor-based treatment, was higher at 12-months than at baseline, whereas creatinine and retinal screening measurements were less frequent. A limited amount of patient feedback was positive.
Case-finding and invitation to flexibly run multidisciplinary clinics were associated with improvements in cardiometabolic outcomes and positive patient feedback. Similar services are immediately required given the rising prevalence of EOT2D and associated complications.
Authors
Goldney Goldney, Hamza Hamza, Sarkar Sarkar, Morgan Morgan, Green Green, Ridgeway Ridgeway, Alabraba Alabraba, Willcocks Willcocks, Chandracant Chandracant, Javed Javed, O'Callaghan O'Callaghan, Turner Turner, Seidu Seidu, Meek Meek, Davies Davies
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