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Poor care for young people with diabetes

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Treatment of young people with diabetes in England and Wales is among the poorest in Europe, an audit by the Royal College of Paediatrics and Child Health (RCPCH) has found.

The news comes despite findings that the quality of care for young people with diabetes in the region is at an eight-year high.

The National Paediatric Diabetes Audit, commissioned by the Health Quality Improvement Partnership as part of the National Clinical Audit and Patient Outcomes Programme, measures the prevalence of diabetes in people under 25 across England and Wales and assesses whether eight key care processes recommended by NICE, are being met.

These include measurements of HbA1c levels (a marker of overall diabetes control), cholesterol, blood pressure and eye screening.

The Audit of 23,676 young people, found despite 90 per cent having had an HbA1c level performed during the audit year, only 6 per cent received all eight key care processes (compared to 4 per cent in 2009/10, and 2 per cent in 2004/05).

The percentage with diabetes whose HbA1c levels are under 7.5 per cent (the NICE-recommended target) is 16 per cent, up from 14.5 per cent in 2009/10.

But despite improvements in care processes and outcomes, these remain 'significantly worse' than those for adults and HbA1c outcomes remain poor in comparison to other countries. The German and Austrian audit showed that 34 per cent of young people with diabetes achieved an HbA1c level of under 7.5 per cent.

The RCPCH audit identified an increase in children with diabetes being admitted with diabetic ketoacidosis (DKA) - a complication that can lead to death if untreated. The incidence per 100,000 has almost doubled since 2005 from 8.5 to 15.

Barbara Young, chief executive of Diabetes UK, said: 'We are disappointed the blood glucose levels in children and young people with diabetes have barely improved since the last audit and a rising number of them have blood glucose that is so out of control they are becoming seriously ill and having to be admitted to hospital. But it is hardly surprising this tragedy is unfolding when the majority are not getting the basic standards of care.'

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