Diabetes care for children and young people

The National Institute for Health and Clinical Excellence provides recommendations on the key age-specific processes for diabetes care for children and young people, which help monitor how diabetes is managed and prevent long-term complications. Here we use audit data to look at seven of these processes for children aged 12 and older as well as HbA1c control.  

See also our analysis of care for adults with diabetes.

How has the proportion of children and young people with diabetes receiving recommended care processes changed over time?

The graph captures the proportion of children and young people over the age of 12 cared for in paediatric diabetes units having a key-specific care process recorded (for HbA1c this is all ages). The percentage of children and young people with diabetes who had their glycated haemoglobin A1c (HbA1c), blood pressure, urinary albumin, cholesterol, BMI (both height and weight) recorded, eyes screened and feet examined has been increasing over time in England and Wales. However, the proportion having their urinary albumin and cholesterol measured, eyes screened and foot examined still lags behind the other processes (HbA1c, BMI, blood pressure).

While the proportion of 12 year olds and older with all care processes recorded has increased from 2% in 2004/2005 to 16.1% in 2013/2014, many children still do not receive the recommended care for diabetes. Comparatively, the proportion of adults receiving all care processes in 2012/13 was approximately 60%.

Furthermore the Audit finds that in England only slightly more than two thirds of children (12+) have their smoking status recorded, 52% have their thyroid function tested, 45% are tested for coeliac disease and 48% receive a psychological assessment (data not shown).

How has HbA1c target achievement for children with diabetes changed over time?

HbA1c levels less than 58 mmol/mol suggest excellent control of diabetes and levels over 80 mmol/mol can lead to serious lifetime complications.

There has been a slight increase in the proportion of children in England and Wales with HbA1c

About this data

For more information see Royal College of Paediatrics & Child Health

Caution should be taken in the interpretation of the change in the HbA1c values due to the difference in the analysis of HbA1c over time. Also, there may be significant underreporting of the care process being performed but not recorded for audit purposes. See audit report for more detail.

Comments

Please note that the National Paediatric Diabetes Audit is delivered by the Royal College of Paediatrics and Child Health, not the Royal College of Physicians. I would be grateful if you would correct the source attribution beneath the figures; these are data from the RCPCH NPDA reports. Thank you.

Neena Modi, RCP... (not verified)
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