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National Paediatric Diabetes Audit (NPDA) annual report on 2023-24 data

Audits team
Our report, published in March 2025, presents the key findings on the health checks and outcomes for children and young people with diabetes mellitus in England, Wales and Jersey. It covers the period from 1 April 2023 to 31 March 2024.

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.

You can view the report below or download it from the bottom of this page. You can also download our 'results at a glance'.

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

Read more about the audit and what we measure

Key messages from the report

  • Prevalence - Despite the incidence of paediatric diabetes in 2023/24 returning to near pre-COVID-19 rates, the prevalence of children and young people (CYP) with diabetes cared for in a PDU in England and Wales has increased by 16% since 2018/19.
  • Completion of health checks - Overall, the completion rate of health checks for Type 1 diabetes at all ages remains high. 92% of all expected health checks were completed, but there is considerable variation between PDUs ranging from 75% to 100%.
  • Median HbAIc - The national (England and Wales combined) median HbA1c for children and young people with Type 1 diabetes has fallen to 60.0 mmol/mol. This is a 0.5 mmol/mol decrease from 60.5 mmol/mol in 2022/23.
  • Microvascular and macrovascular abnormalities - There have been limited improvements in the national rates of microvascular and macrovascular abnormalities despite decreases in HbA1c and the increased use of technologies.
  • BMI - 94% of CYP with Type 2 diabetes had a BMI in the overweight or obese range, compared to 42% of CYP with Type 1 diabetes.
  • Diabetes-related technologies use - The percentage of children and young people with Type 1 diabetes using diabetes related technologies has increased. The use of advanced technology to deliver insulin and monitor blood glucose levels is associated with a lower HbA1c.
  • Hospital admission and diabetic ketoacidosis (DKA) - The rates of post-diagnosis hospital admissions in 2023/24 are stable and the incidence of DKA at diagnosis of Type 1 diabetes also remains stable at 26%.
  • Inequalities related to ethnicity and deprivation - These remain prevalent:
    • The mean HbA1c for Black CYP with Type 1 diabetes has increased to 71.0 mmol/ mol from 70.0 mmol/mol in 2022/23 and remains higher than that seen in their White equivalents of 63.0 mmol/mol.
    • The average HbA1c gap remains the same between the most and least deprived quintiles: 66.0 and 60.0 mmol/mol respectively in 2023/24, compared to 66.8 and 59.9 mmol/mol in 2022/23.
    • The technology usage (rtCGM, insulin pumps and Hybrid Closed Loop systems) is less prevalent amongst ethnic minority groups and those living in deprived areas.

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