Paediatric to adult diabetes services transitional report published
The transition of care from paediatric to adult services is the subject of a new report which has just been published.
The National Diabetes Transition Audit (NDTA) links datasets from the adult and paediatric national diabetes audits and examines whether the transition between childhood and adulthood has an effect on care.
The NHS Digital report includes figures on the percentage of people who are receiving the nine NICE recommended care processes, as well as the percentage of people who have met the NICE treatment targets for diabetes care.
The report also examines how young people with type 1 diabetes are monitored against risk factors which are associated with diabetes care as well as diabetic ketoacidosis (DKA) inpatient admissions.
Some of the key findings include a decrease in annual HbA1c measurements after the transition, as have check completion rates for kidney, foot, retinopathy and smoking.
The differences in care process completion pre and post transition do not appear to be influenced by gender, ethnicity, or living in a deprived area.
It was also found that the completion of pre-transition annual care processes fall as age at transition increases, while post-transition completion rates increase as age at transition increases. A similar pattern is seen for duration of diabetes.
The least variation in care process completion rates was found where transition occurred between the age of 16 and 19 years. This may be because planned transition usually occurs during this time window. Planned movement from paediatric to adult care is less likely at younger and older ages.
In terms of treatment targets, the recommended HbA1c levels are more likely to be reached pre-transition compared to post-transition; the difference is greatest at younger ages.
The decrease in meeting the HbA1c target is not influenced by gender, ethnicity, or living in a deprived area.
For both cholesterol and blood pressure, the percentage of children achieving the targets are higher pre-transition compared to post-transition.
The findings also suggested there are a higher number of DKA admissions post-transition. However, this could be due to the fact that DKA rates increase with increasing duration of diabetes.
Information has been collated between 2003 and 2014 from the National Diabetes Audit (NDA) – adults and the National Paediatric Diabetes Audit (NPDA).