The National Institute for Health and Care Excellence (NICE) 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.
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 feet examined still lags behind the other processes (HbA1c, BMI, blood pressure).
The proportion of 12 year olds and older with all care processes recorded has increased from 2% in 2004/2005 to 35.5% in 2015/2016. However, many children still do not receive all recommended care processes for diabetes.
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 below 58mmol/mol in the last year to 26.6%. At the same time there has been a slight decline in the proportion of those who have HbA1c over 80mmol/mol from 28.7% in 2011/12 to 17.9% in 2015/16; however this figure still suggests almost one fifth of children and young people with diabetes have unacceptably high 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.
The 2015/16 diabetes audit report gives data for both Type 1 and Type 2 diabetes care processes. For Type 1 diabetes, thyroid screening is one of the key care processes, instead of cholesterol. For this reason, we cannot compare cholesterol screening levels with previous years, as the newest data is only for children and young people with Type 2 diabetes. The figure given for completion of all care processes corresponds to Type 1 care processes only - but since Type 1 diabetes accounts for 95% of all cases for children and young people, the improvements reported here can be taken to reflect real improvements in care process completion or completeness of data submitted to the NPDA.
See the audit report for more detail.