Despite improvements in care for children and young people with diabetes, outcomes related to future health risk in over 25% remains 'unacceptable,' according to a new report published December 16th 2013 by the Royal College of Paediatrics and Child Health (RCPCH).

The National Paediatric Diabetes Audit (NPDA) covering the period 1st April, 2011 to 31st March 2012, measures the prevalence of diabetes in children and young people, and assesses whether the seven key care indicators recommended by the National Institute for Health and Care Excellence (NICE) are met. These include measures of HbA1c (a marker of overall diabetes control), Body Mass Index, urinary albumin, blood cholesterol, blood pressure, foot examination and eye screening.

Having unacceptable overall diabetes control, assessed by high levels in the blood test HbA1c, increases the risk of children and young people developing long-term complications over the course of their lifetime, as a result of poor diabetes care.

The audit, commissioned by the Health Quality Improvement Partnership (HQIP) as part of the National Clinical Patient Outcomes Programme (NCAPOP) and involving 25,199 children and young people under the age of 25 years with diabetes cared for in Paediatric centres across England and Wales also found:

  • The percentage of children and young people with diabetes considered to have good control has increased from 14.5% in 2009-10 to 17.4% in 2011-12
  • Only 6.7% of children are documented to have received all seven care processes recommended by NICE (a care process is a blood test or physical examination which should be performed annually as part of the care for a patient with diabetes)
  • The percentage of type-2 diabetes in children and young people attending paediatric diabetes units is highest in Asian children

Dr. Justin Warner, RCPCH lead and a Consultant in Paediatric Endocrinology and Diabetes, said:

"Diabetes is a serious, yet manageable condition. It is heartening to see some improvement in numbers of children and young people with diabetes achieving excellent control of the disease, but is also concerning that significant numbers of children still do not have access to a level of control that would reduce their risk of developing disease-associated complications long-term.

"Action to improve diabetes outcomes for more children has been taken in England, where Best Practice Tarif has been introduced to enable centres providing paediatric diabetes care to enhance their resource and service delivery. Peer review will provide further quality assurance to ensure high standards of care are met.

"With recent evidence suggesting that the incidence of Type 1 diabetes in children is rising and may double by 2020, getting the management of care right for every child is essential to ensure they have the best quality of life."