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Only one in five young adults with diabetes gets all required checks

Young people falling through gaps in adult and children’s services

Caroline White

Thursday, 08 March 2012

Young adults with diabetes are getting a raw deal, with only one in five 16 to 24 year olds with the condition being given all the recommended care checks they need, indicates new research.

The findings, which were presented at the Diabetes UK Professional Conference 2012 today, come as NHS Diabetes publishes a report highlighting significant gaps in the care of young people with type 1 disease.

The authors analysed data from the 2009-10 National Diabetes Audit (NDA),  which included 1.9 million people or 83% of those with diagnosed diabetes in England. It found that 16 to 24 year olds are the least likely of all age groups in England to receive the health checks and services they need.

Just 20 per cent went through all the assessments, including eye exams and foot checks, recommended by the National Institute for Health and Clinical Excellence (NICE). 

Charity Diabetes UK is calling on the NHS to do more to stop young adults with diabetes falling through the gap between children’s and adult healthcare services.

Simon O’Neill, the charity’s director of care, policy and intelligence said: “It is crucial that young people with diabetes have access to all of the care checks they need to manage their condition properly because this can help keep their diabetes under control and enable them to live long and healthy lives. But this study shows the quality of care for young adults is not good enough.”

Improving healthcare at this stage, could prevent the huge personal and financial costs of having to treat subsequent complications, such as heart disease, stroke, kidney disease, blindness and amputation, he said.

“There are likely to be a number of reasons for this [poor care],” he suggested. “But one of them is that the change from children’s to adult services is not smooth enough at the moment. Too many young people are falling off the radar in terms of diabetes care.” 

Poor diabetes control and management was common among the under 55s, the study showed. People in this age band were less likely to achieve their target blood glucose levels than older people, with only half of those with type 2 diabetes achieving the average measurement of blood glucose (HbA1c) treatment target. 

More than one in 10 of all heart attacks and 15 per cent of major amputations in people with the condition occurred people under 55, the data showed.

Meanwhile a new report from NHS Diabetes has highlighted “discrepancies” between children and adult type 1 diabetes services.

The report, which draws on discussions with young people with type 1 diabetes, their families and professionals in nine acute trusts throughout the Yorkshire and the Humber region, has prompted the national diabetes service improvement team to make a series of recommendations.

Among them is the requirement for standardised and formal diabetes training for every professional working with children and young people with diabetes. Clinics, schools, colleges and psychological support were highlighted as areas which needed additional diabetes support.

The team also wants a transition plan to be introduced into all diabetes services, and the adoption of a holistic approach to diabetes care, with young people and their parents actively involved.

A universal record-keeping system should also be implemented across all diabetes services, it says.

Anna Morton, Director of NHS Diabetes said: “All too often we are finding discrepancies between services, particularly in transitional care. Equity of service is the key issue. All children and young people should receive high-quality, cohesive care throughout their diabetes journey.”

National Diabetes Audit (NDA): routine care is less effective and outcomes poorer in younger people as compared with older people who have diabetes in England. Diabetic Medicine 29 (Supp 1); P141.

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