It aims to understand what proportion of patients seen in paediatric diabetes units receive key age-specific processes of diabetes care, as recommended by NICE and achieve outcomes within specified treatment targets. It also looks at whether patients demonstrate evidence of small vessel (microvascular) disease and/or abnormal risk factors associated with large vessel (macrovascular) disease before they transition into adult services.
Report on care and outcomes
Download report on care and outcomes 2024-25 (PDF)
Download results at a glance (PDF)
- Background to NPDA
The 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, Wales and Jersey. 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.
Our aims:
- Monitor the incidence and prevalence of all types of diabetes amongst children and young people receiving care from a PDU in England, Wales and Jersey
- 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
Key messages from the report
- Prevalence - The number of children and young people receiving care from paediatric diabetes units continues to rise. In 2024/25, 35,801 children and young people were receiving care across England, Wales and Jersey, representing a 29% increase in caseload over the past decade.
- Completion of health checks - Completion of recommended health checks for children and young people with Type 1 diabetes remains relatively high overall, but is. However, gaps persist: in 2024/25, 28% of young people (aged 12+) with Type 1 diabetes missed one or more recommended checks. For those with Type 2 diabetes, completion is much lower. 60% of young people with Type 2 diabetes missed one or more health checks in 2024/25.
- Median HbA1c - The national (England, Wales and Jersey combined) median HbA1c for children and young people with Type 1 diabetes has fallen further to 58.0 mmol/mol. Differences in HbA1c related to deprivation and ethnicity have narrowed slightly in 2024/25 but remain present.
- Microvascular and macrovascular outcomes - The prevalence of early markers of microvascular and macrovascular disease has remained largely unchanged in 2024/25, despite continued improvements in HbA1c. Children and young people with Type 2 diabetes continue to show higher rates of risk factors such as obesity, hypertension, albuminuria.
- Diabetes-related technologies use - Use of diabetes technologies among children and young people with Type 1 diabetes continues to increase, and hybrid closed loop (HCL) systems in particular are associated with better HbA1c outcomes. However, access to HCLs varies widely between PDUs.
- Hospital admission and diabetic ketoacidosis (DKA) - Rates of hospital admission following diagnosis have declined in recent years, but diabetic ketoacidosis at diagnosis remains a concern. In 2024/25, 22% of children and young people were in DKA at the time of diagnosis, with particularly high rates in the youngest age groups.
Related resources
Unit level reports and posters on SharePoint - you can print and display the posters in your clinic waiting area or email to your contacts
Reporting dashboards - view unit-level summaries, compare results across regions, check outlier positions and access historic data from the previous NPDA Results Online platform
Additional data files on specific measures
Parents and carer reports - providing a lay summary of the findings from the annual summary reports, in English and Welsh