Clinical

Diabetes: care and control for children in England and Wales ‘significantly improved’

There has been continued improvement in diabetes care and control among children over the last six years, according the annual national audit.

The number of children and young people with Type 1 diabetes achieving excellent diabetes control has increased from 17% (2013/14) to 27% (2015/16).

The National Paediatric Diabetes Audit (NPDA) by the Royal College of Paediatrics and Child Health (RCPCH) also shows the number of children and young people with Type 1 diabetes with poor diabetes control fell from 24% (2013/14) to 18% (2015/16).

Furthermore, more centres delivering care are completing vital health checks on feet, kidneys and eyes.

Paediatric diabetes experts say years of interventions continue to yield positive results. The average blood glucose level, (HbA1C, a marker which measures overall diabetes control), in children and young people with diabetes in England and Wales has improved for the sixth consecutive year, with more children than ever achieving excellent control.

This substantially reduces the long-term risks of complications from the disease.

The NPDA, now in its 13th year, looked at data from all 28,439 children and young people with diabetes who attended 173 paediatric centres delivering diabetes care in England and Wales between 1 April 2015 and 31 March 2016 (100% participation rate).

Almost all children and young people with Type 1 diabetes had an HbA1c (99%) and a height and weight measured (98%) during the audit year. Two thirds of young people underwent essential foot checks (66%) compared with 55% in the previous year.

Two thirds (66%) were screened for complications relating to their eyes (retinopathy screening), up from 64% in the previous year and 66% were screened for kidney complications (urinary albumin), an improvement from 52% in the previous year.

Dr Justin Warner, clinical lead for the NPDA and member of the Royal College of Paediatrics and Child Heath, said: “The impact of the improvement in blood glucose levels over the last six years should not be underestimated and will reduce the risk of future complications significantly. The improvements reflect the massive amount of work and quality improvement provided by healthcare teams, parents and patients.”

However, despite seeing these improvements, deficiencies in care still remain.

  • There remains considerable variability between centres across England and Wales providing care in terms of diabetes outcomes which require better working relationships, sharing of good practice and instigation of quality improvement strategies to improve care.
  • 9.7% of young people with Type 1 diabetes are already demonstrating early signs of kidney disease and 13.8% early signs of eye disease putting them at increased risk of kidney failure and blindness
  • Children with Type 1 diabetes were more likely to be overweight or obese compared to the general population.
  • Children and young people living in the most deprived areas were at increased risk of diabetes complications and poor diabetes control compared to those in the least deprived areas.
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