National Paediatric Diabetes Audit (NPDA) annual reports

Our annual, national reports, 'Care processes and outcomes' highlight the main findings on the quality of care for children and young people with diabetes mellitus in England and Wales. On this page you can download our latest and previous reports, and find links to our reports especially for parents and carers.
NPDA Annual Report cover, with the hashtag #npda2023

Annual report 2022/23: Care processes and outcomes

Published in April 2024, the 2022/23 report covers the health checks (care processes) and outcomes for children and young people with diabetes who have attended PDUs (paediatric diabetes units) from 1 April 2022 to 31 March 2023.

The report aims to address a series of questions relating to paediatric diabetes care, which include:

  • What proportion of children and young people with diabetes are reported to be receiving key age-specific processes of diabetes care, as recommended by NICE?
  • How many achieve outcomes within specified treatment targets?
  • Are children and young people with diabetes demonstrating evidence of small vessel (microvascular) disease and/or abnormal risk factors associated with large vessel (macrovascular) disease prior to transition into adult services?

The annual report is accompanied by a two page infographic, summarising the results reported in the national report, and a case study from University Hospitals Birmingham NHS Foundation Trust. This case study details how they supported families to adopt using a closed loop system.

You can download the 2022/23 report below.

Key messages

  • The prevalence of children and young people cared for in PDUs in England and Wales has increased from 33,251 in 2021/22 to 34,371 in 2022/23, despite a fall in the incidence of new cases.
  • The percentages of children and young people with Type 1 and Type 2 diabetes receiving all six key annual healthcare checks has increased but there remains much variability between PDUs, and completion rates for those with Type 2 remain lower than for those with Type 1.
  • The overall median HbA1c for England and Wales has fallen from 60.5mmol/mol in 2021/22 to 60.0mmol/mol, but excessive PDU variability in this outcome measure still persists.
  • Percentages of young people with early signs of micro and macrovascular complications for both Type 1 and Type 2 diabetes show very little change in 2022/23 compared to the previous audit year.
  • Use of diabetes related technology has increased in 2022/23 with around half of children and young people with Type 1 diabetes using insulin pumps (45.3%, compared to 40.3% in 2021/22) and half (48.6%, compared to 30.0% in 2021/22) using a real time continuous glucose monitor (rtCGM). Use of hybrid close loop systems doubled since the previous audit year, with 14.7% now using this technology compared to 7.5% in 2021/22.
  • Lower HbA1c was associated with use of a hybrid closed loop system or rtCGM.
  • Around a quarter (23.3%) of all new cases of Type 1 diabetes had diabetic ketoacidosis (DKA) at diagnosis compared to 25.6% in 2021/22.
  • Despite improvements in outcomes and use of technologies across different ethnicities and areas of deprivation, inequalities remain evident. In terms of rtCGM use, the inequality gap by deprivation has reduced. However, the difference in use between Black and White children with Type 1 diabetes has widened from 8.6% in 2021/22 to 14% in 2022/23.

Individual unit level reports

You can download your unit level report from our dedicated SharePoint site.

You can access individual unit level reports since 2014 on our interactive tool, NPDA Results Online.

Individual unit level posters

Summary and feedback posters for your unit level 2022/23 audit year results are also available to download from our SharePoint site. These posters can be printed for display in your clinic waiting area, or can be shared with your contacts via email.

Additional data files

As part of our commitment to open data, we have made available our data files on specific measures from the audit.

Previous years' reports

Previous years' reports are available in the downloads section.

    Parents and carers reports

    Our parents and carers reports provide a lay summary of the findings from the NPDA annual reports. We produce versions in English and Welsh.

    We will be uploading our latest parents and carers report shortly and will communicate to all units when this is available to download from our parents and carers report page.

    Background and audit aims

    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 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.

    Our aims:

    • 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

    You can read more about the audit and what we measure.

    NPDA reporting webinar, February 2024

    NPDA Manager Holly Robinson and NPDA Analyst Cillian Brophy hosted a webinar and Q&A in February to explain the processes involved in cleaning, analysing and reporting the core NPDA dataset, including upcoming plans for quarterly reporting and provision of data for hybrid closed loop reimbursement.