Guidelines endorsed by RCPCH - Diabetes and endocrinology

The College reviews high quality guidelines and standards produced and published by other organisations against the RCPCH Standards for Endorsement. We believe the following publications will be of interest to paediatricians working in this diabetes and endocrinology.

The following have been endorsed by the College:

Endorsed guidelines

 

Diabetes (type 1 and type 2) in children and young people: diagnosis and management (NICE)

Diabetes is a long-term condition that can have a major impact on the life of a child or young person, as well as their family or carers. In addition to insulin therapy, diabetes management should include education, support and access to psychological services, as detailed here and in this guideline. Preparations should also be made for the transition from paediatric to adult services, which have a somewhat different model of care and evidence base.
 
This guideline is of relevance to those who work in or use the National Health Service (NHS) in England and Wales, in particular:
  • paediatric endocrinologists, paediatric dietitians, paediatric diabetes specialist nurses, general practitioners 
  • those responsible for commissioning and planning healthcare services, including primary care trust and local health board commissioners, Wales commissioners and public health and trust managers
  • children and young people with type 1 or type 2 diabetes and their families or carers.
Date of Publication: August 2015
Endorsed on: March 2016 
 
Full Clinical Guideline (PDF, 4,609KB, 517 Pages) 
NICE Clinical Guideline (PDF, 335KB, 92 Pages)
 

Diabetes in children and young people (NICE)

Diabetes is a long-term condition that can have a major impact on the life of a child or young person, as well as their family or carers. In addition to insulin therapy, diabetes management should include education, support and access to psychological services. Preparations should also be made for the transition from paediatric to adult services, which have a different model of care and evidence base.

This quality standard covers the diagnosis and management of type 1 and type 2 diabetes in children and young people aged under 18. It is expected to contribute to improvements in the following outcomes:

  • prompt diagnosis of type 1 diabetes
  • glycaemic control: blood glucose and HbA1c levels
  • diabetes complications
  • quality of life
  • patient, parent and carer satisfaction
  • life expectancy

RCPCH notes: 

The RCPCH asks its members to note that the quality standards does not provide information on children and carers with marked anxiety about nocturnal hypoglycaemia, or young children who are unable to communicate their symptoms of hypoglycaemia, and screening for emotional health and wellbeing.

Date of Publication: July 2016
Endorsed on: August 2016

Full Quality Standard (PDF, 194KB, 40 Pages) 
 

Diabetic foot problems - prevention and management (NICE)

Foot complications are common in adults with diabetes. It is estimated that 10% of adults with diabetes will have a diabetic foot ulcer at some point in their lives. A foot ulcer can be defined as a localised injury to the skin and/or underlying tissue, below the ankle, in a person with diabetes. 
 
This guideline covers preventing and managing foot problems in adults with diabetes, with an emphasis on the education of children and young people in foot care in preparation for transition to adulthood. The guideline aims to reduce variation in practice.
 
Date of Publication: August 2015
Endorsed on: January 2016
 
Full clinical guideline (PDF, 2802KB, 282 Pages) 
NICE guideline (PDF, 217KB, 46 Pages)
 

Investigations in Hypernatraemia (RCPCH)

This guideline is based on a systematic review of the literature relating to hypernatraemia and salt poisoning. It will provide evidence-based guidance on the differential diagnoses for hypernatraemia in children and on what investigations should be undertaken when children present, and the interpretation of the results of investigations.

The guideline is accompanied by an executive summary.

Date of Publication: July 2009
Date of Endorsement: April 2009

Full guideline (PDF, 0.99KB, 114 Pages)
 

Management of Obesity (SIGN)

The guideline covers the primary prevention of obesity, the treatment of obesity by diet and lifestyle, the treatment of obesity by pharmacological and surgical treatment and the prevention of weight regain following treatment, in adults, children and young people.

The guideline includes key messages for parents, BMI charts, and healthy eating advice for children.

Date of Publication: February 2010
Date of Endorsement: June 2010

Full guideline (PDF, 1.6MB, 96 Pages)
Quick reference guide (PDF, 1.1MB, 20 Pages)
 

Obesity: Identification, assessment and management of overweight and obesity in children, young people and adults (NICE)

Overweight and obesity is a global problem. The World Health Organization predicts that by 2015 approximately 2.3 billion adults worldwide will be overweight, and more than 700 million will be obese.
 
In the UK obesity rates nearly doubled between 1993 and 2011, from 13% to 24% in men and from 16% to 26% in women. In 2011, about 3 in 10 children aged 2–15 years were overweight or obese.
 
This guideline addresses three main areas: 
  1. follow‑up care packages after bariatric surgery; 
  2. the role of bariatric surgery in the management of recent-onset type 2 diabetes; 
  3. very-low-calorie diets including their effectiveness, and safety and effective management strategies for maintaining weight loss after such diets. 
Date of Publication: November 2014
Endorsed on: July 2015
 
Full clinical guideline (PDF, 318KB, 65 Pages)
 

Obesity: prevention and lifestyle weight management in children and young people (NICE)

This quality standard covers a range of approaches at a population level to prevent children and young people aged under 18 years from becoming overweight or obese. It includes interventions for lifestyle weight management. 
 
These statements are particularly relevant to local authorities, NHS organisations, schools and providers of lifestyle weight management programmes.
 
The quality standard is expected to contribute to improvements in the following outcomes:
  • excess weight in children and young people under 18 years
  • dietary habits
  • time spent being inactive or sedentary
  • prevalence of type 2 diabetes in children and young people
  • use of children and adolescent mental health services (CAMHS)
  • self-esteem
  • mental wellbeing
Date of Publication: July 2015
Endorsed on: July 2015
 
Full quality standard (PDF, 227KB, 44 Pages)
 

Obesity: prevention, identification, assessment and management of overweight and obesity in adults and children (NICE)

The guideline covers the prevention, identification, assessment and management of overweight and obese adults and children over the age of two. It is particularly relevant to all healthcare professionals working with overweight and obese adults and children in primary, secondary and where appropriate, tertiary care. The guideline includes public health recommendations as well as clinical recommendations.

The guideline is accompanied by a costing report and template, audit support, an implementation support tool, slide sets (one of which is aimed at schools), a commissioning guide and an online educational tool.

The RCPCH welcomes the publication of this guideline but asks Members to note the following:

The guideline recommends that individuals follow a low-fat diet. It is not made clear in the guideline, but this should be read alongside the sources of advice and information listed in Appendix D of the NICE guideline. The RCPCH recommends that advice regarding minimising sedentary activities be supplemented by a cap on television viewing time of two hours.

Date of Publication: December 2006
Date of Endorsement: May 2008

Full guideline (PDF, 1.33MB, 189 Pages)
NICE guideline (PDF, 998KB, 84 Pages)
 

Sleep Physiology and Respiratory Control Disorders in Childhood (RCPCH)

This guideline covers the diagnosis and management of disorders of sleep physiology and respiratory control in children and the organisation of such services nationally. It is particularly relevant to parents, primary and secondary care physicians, surgeons and health service managers.

The guideline is accompanied by an executive summary and lay summaries and includes a proforma for peer review of sleep services, discussion of services and resource implications and key points for audit.

Date of Publication: September 2009
Date of Endorsement: June 2008

Full guideline (PDF, 1.15MB, 144 Pages)
Executive summary (PDF, 398KB, 40 Pages)
Lay summary 1- Sleep Services and Sleep Studies (PDF, 34KB, 3 Pages)
Lay summary 2- Obstructive Sleep Apnoea (PDF, 37KB, 3 Pages)
Lay summary 3- Obstructive Sleep Apnoea in Downs Syndrome (PDF, 21KB, 2 Pages)
Lay summary 4- Sleep Related Breathing Disorders in Children with Neuromuscular Disease (PDF, 21KB, 2 Pages)
Lay summary 5- Obstructive Sleep Apnoea in Children with Craniofacial Abnormalities (PDF, 35KB, 2 Pages)
Lay summary 6- Sleep Related Breathing Disorders in Children with Prader-Willi Syndrome (PDF, 21KB, 2 Pages)
Lay summary 7- Congenital Central Hypoventilation Syndrome (PDF, 20KB, 2 Pages)
Lay summary 8- Narcolepsy (PDF, 20KB, 1 Page)
 

Transition from children’s to adults' services for young people using health or social care services (NICE)

Transition occurs during the period when young people and their families are thinking about their hopes for the future. If people are likely to have care and support needs when they are 18, they need information and advice so that they can make the necessary plans. Despite this, there is evidence that the transition process is variable, with previous good practice guidance not always being implemented.
 
This clinical guideline focuses on young people passing through transition to adult services with health and/or social care needs. 
 
It covers the period before, during and after a young person moves from children's to adults' services, and aims to help young people and their carers have a better experience of transition by improving the way it’s planned and carried out.
 
Date of Publication: February 2016
Endorsed on: March 2016
 
Full Clinical Guideline (PDF, 1,710KB, 218 Pages)
NICE Clinical Guideline (PDF, 173KB, 31 Pages)