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Children missing out on diabetes checks

By Editor
31st May 2016
Audits, Charity Clinical guidance Good practice Latest news

Almost 75 per cent of children who have diabetes in England and Wales are not receiving the key health checks they are entitled to, a study has said.

Out of a total of 27,682 children and young people the data showed that only 25.4 per cent of those aged 12 and older had all seven recommended annual checks.

Despite that, the Royal College of Paediatrics and Child Health, which carried out the audit, said that average HbA1C levels has reduced for the fifth consecutive year.

The figures come from the 12th National Paediatric Diabetes Audit (NPDA) which gathers data from children and young people who attended paediatric diabetes units in England and Wales between 1 April 2014 and 31 March 2015.

‘Continued improvement’

Dr Justin Warner, clinical lead for the NPDA and member of the Royal College of Paediatrics and Child Heath, said: “These health checks are important. They form part of a lifetime of screening for complications which, if recognised early are amenable to interventions that reduce progression.”

The number of children achieving excellent diabetes control has increased from 15.8 per cent to 23.5 per cent.

Dr Warner added: “It is extremely heartening to see continued improvement in outcomes for children and young people with diabetes.

It is extremely rewarding for doctors and patients to see positive results starting to emerge after the time they have spent trying to improve diabetes care for children

“There have been many changes in the landscape for paediatric diabetes over the last five years including the establishment of managed networks and quality assurance measurements.

“Furthermore, the publication of service delivery plans in England and Wales and the ‘best practice tariff’ in England has enabled trusts and health boards delivering care to improve the quality of service they provide. The investment is paying off with continued quality improvement.”

Nearly two thirds of young people with diabetes over the age of 12 had their eyes screened and just over half received a test to determine whether their kidneys are damaged.

‘Considerable variation’

Dr Justin Warner, said: “It is extremely rewarding for doctors and patients to see positive results starting to emerge after the time they have spent trying to improve diabetes care for children.

“The rate of improvement seen in England and Wales has exceeded that seen in some other European countries. However, we will not rest on our laurels as the variability in outcomes seen across the two nations remains excessive and ongoing improvements are still required.”

NICE guidelines state that all children with diabetes should have their HbA1C levels checked and those over the age of 12 should have six other regular health care checks performed annually.

These include measures of growth, blood pressure, kidney function, cholesterol, eye screening and foot examination.

Responding to the recent figures, Diabetes UK said it is “worrying” that not everyone is receiving the relevant checks.

Bridget Turner, Diabetes UK’s director of policy and care improvement, said: “It is really good news that the numbers of children and young people with diabetes in England and Wales meeting their target blood glucose levels and receiving all of the recommended checks is increasing.

“This shows that strategies to improve care, for example the Paediatric Diabetes Best Practice Tariff, the specialist paediatric networks, and the peer review along with the hard work of Paediatric Diabetes Units, is really working.

“However, there are still many children and young people with diabetes who are not achieving recommended blood glucose targets, or receiving all the checks they should.

“There remains considerable variation in the level of care provided. This is very worrying because if children and young people are not supported to manage their diabetes well in early life, they are more likely to be at risk of debilitating and life-threatening complications in adult life such as amputations, blindness and stroke.

“This is why it is essential that local services continue on their improvement journey working with and supporting children and young people with type 1 diabetes and their parents and carers, to be fully engaged in their care.”

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