Thousands of children and young people with diabetes are at risk of sight loss, kidney failure and heart problems because their condition is dangerously out of control, according to a report by The NHS Information Centre.
Nearly three out of ten children and young people with diabetes in England and Wales have high-risk blood sugar levels (Haemoglobin A1c above 9.5%) – a level which, according to the National Institute for Health and Clinical Excellence, seriously threatens future health and should attract extra resources for care. The number is a slight decrease on the previous year. However, it remains a significant cause for concern because the measure indicates the number of children and young people who are likely to face major health complications in the future. The National Diabetes Audit (NDA) is carried out by The NHS Information Centre on behalf of the Healthcare Quality Improvement Partnership to encourage consistent standards of care across the country. Overall, the report shows that the care of people with diabetes is improving with more people having the key tests and measurements they need to help keep their diabetes under control. However, the report also shows that substantial numbers of children and young people with the condition are failing to get the care they need and as a result face serious health consequences. The report also highlighted a big increase over the past four years in the number of diabetics being treated for kidney failure as a result of their condition. Some 30% more diabetics are on dialysis or have a kidney transplant now than in 2002/03. This may be due to an increase in the availability of kidney treatment as well as an increase in people needing it. It also found that 60% of people registered with diabetes do not get all the health checks they need on an annual basis. A report, released by the charity Diabetes UK, also shows that the health of children with diabetes is being put at increased risk because paediatric diabetes specialist nurses (PDSNs) are severely overstretched. The report shows that some PDSNs in Primary Care Trusts (PCTs) in England look after more than 150 children, compared to the recommended 70. Such a large case load does not allow nurses the necessary time to help children manage their diabetes and give them individual advice and support. The report also shows that the PDSN caseload in 35% of PCTs has increased since 2007, and less than 7% of PCTs have improved their PDSN caseload. This is despite the fact more than 80% of children with diabetes are not achieving recommended blood glucose levels. Douglas Smallwood, chief executive of Diabetes UK, said: “Services must improve now otherwise our children risk developing serious, long term complications of diabetes such as losing their sight or needing kidney dialysis in later life. The Government promised six years ago to improve specialist care and ensure a healthy future for all children with diabetes, but standards remain patchy.” The report also found that some PCTs do not employ any PDSNs at all.
