National Paediatric Diabetes Audit 2015-16 annual report

This report highlights the main findings on the quality of care for children and young people with diabetes mellitus in England and Wales. You can download the full reports below.

About diabetes

Diabetes is a condition where the amount of glucose in the blood is too high because the body cannot use it properly. High blood glucose levels over time may cause complications associated with diabetes including damage to small and large blood vessels and nerves. Over time this can result in blindness, kidney failure, heart disease, stroke, and amputations.

However, with good diabetes care and blood glucose control, the risks of complications are markedly reduced, enabling children and young people with diabetes to live a healthy, happy and longer life.

About the audit

The National Paediatric Diabetes Audit (NPDA) was established to compare the care and outcomes of all children and young people with diabetes receiving care from Paediatric Diabetes Units (PDUs) in England and Wales. The audit is commissioned by the Health Quality Improvement Partnership (HQIP), funded by NHS England and the Welsh Government, and is managed by the Royal College of Paediatrics and Child Health.

This is the 13th annual report of the audit.

Audit aims

The audit’s aims are to:

  • monitor the incidence and prevalence of all types of diabetes amongst children and young people receiving care from a PDU in England and Wales
  • establish which key care processes are being received by children and young people with diabetes
  • enable benchmarking of performance against standards of care specified by the National Institute for Health and Care Excellence (NICE) guidance at PDU and national level
  • determine the prevalence and incidence of diabetes-related complications amongst children and young people with diabetes.

Audit scope

The 2015-16 NPDA included all 173 PDUs in England and Wales, and captured information on 28,439 children and young people up to the age of 24 years under the care of a consultant paediatrician.

What the audit measures

The audit collects data submitted by PDUs detailing patient demographics, completion of health checks (care processes) and outcome measures of performance.

Quality standards used

The health checks (care processes) audited were those recommended by NICE in their guidance for the diagnosis and management of children and young people with Type 1 and Type 2 diabetes (NG18, NICE, 2015).

Comparison between regions, PDUs and patients

Prevalence and incidence of diabetes, associated complications, and completion of health checks (care processes) are broken down by age group, gender, type of diabetes, deprivation (using Indices of Multiple Deprivation based on patient postcode), region and country.

Since gender, ethnicity, age and deprivation are known to impact upon the level of diabetes control typically achieved by patients as reflected in mean HbA1c levels, case-mix adjusted mean HbA1c levels are presented so that PDU performance can be fairly represented taking these factors into account.

Report structure

For the first time, the audit has reported the care process and outcomes achieved separately for patients with Type 1 and Type 2 diabetes. This executive summary contains key findings and recommendations from the audit which are presented in more detail in later chapters.

Overall national HbA1c results

  • There have been reductions of 3.2 and 2 mmol/mol respectively in the national mean and median HbA1c for all children and young people being treated within a PDU in England and Wales since 2014/15.
  • There has been a 8.5mmol/mol reduction in median HbA1c in England and Wales for children and young people with diabetes over the last 6 years from 73mmol/mol in 2009/10 to 64.5mmol/mol in 2015/16.
  • The national median in 2015/16 for all children and young people being managed within a PDU with all types of diabetes was 64.5mmol/mol, and the national mean was 67.8 mmol/mol.

Key findings: Type 1 diabetes

  • Incidence, prevalence, and patient characteristics
  • Completion of health checks
  • Blood glucose diabetes control targets (HbA1c)
  • Microvascular complications
  • Macrovascular complications and risk factors
  • Thyroid and coeliac disease amongst children and young people with Type 1 diabetes
  • Outcomes of psychological assessment

Key findings: Type 2 diabetes

  • Incidence, prevalence, and patient characteristics
  • Completion of health checks
  • Structured education for self-management
  • Blood glucose diabetes control targets (HbA1c)
  • Microvascular complications
  • Macrovascular complications and risk factors
  • Outcomes of psychological assessment