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Type 1 diabetes complications on rise in children, warns annual audit

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More children are showing early signs of serious complications from type 1 diabetes, a major audit of the condition has revealed.

National Paediatric Diabetes Audit, published today, said there was a “worryingly high” number of young people aged 12 and over showing early signs of potentially serious complications.

It found 27.5% of young people with type 1 diabetes had high blood pressure, over 7% had excess protein in their urine indicative of a high risk of future kidney disease, and over 14% had early signs of eye disease.

In addition, nearly one in five children with diabetes, aged 0-11, and one in four over the age of 12 were classed as obese.

“We have to bridge the gap between best and worst”

Justin Warner

As well as more complications, the audit also found an increase in the actual number of children with type 1 diabetes in England and Wales, identifying 1,000 more than was reported in 2013-14.

A total of 26,867 children and young people with diabetes, aged 0-25 years, were registered as being cared for in a paediatric diabetes unit in 2013-14, compared to 25,221 in 2012-13.

Meanwhile, despite the quality of care improving overall, the audit report said “significant variation” across regions and between units remained, with patients from deprived areas and ethnic minorities having poorer outcomes.

The highest prevalence was in Wales and the South West of England, it said.

However, the audit report noted that there was a “positive story” on diabetes control.

The overall percentage of children and young people with “excellent” control has improved steadily over the last two years, it said. In 2012-13, 15.8% had excellent control, rising to 18.4% in 2013-14.

The report added that type 2 diabetes accounted for less than 5% of cases of diabetes in children and young people, but they were more likely to come from the most deprived areas of the country.

Dr Justin Warner, clinical lead for the audit, said: “On the one hand the picture is positive; the quality of care for children and young people with diabetes is improving and we’re getting better at ensuring care processes are met. 

“Yet the challenge we face is also growing, with more children being diagnosed with diabetes and some displaying early signs of potentially serious long term health problems,” he said.

He noted that tight overall diabetes control was important to reduce the risk of complications later in life, highlighting that this required a close partnership between healthcare professionals, children and families.

Dr Warner said: “It’s the aim of all healthcare professionals providing support for children and young people with diabetes to ensure – wherever they live and whatever their background – they have the best possible care. 

“At the moment, the variability highlighted by the audit demonstrates that this is simply not the case,” he said. “We have to bridge the gap between best and worst, share best practice and continue to drive up the quality of care for all patients.”

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