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Diabetes report calls for better awareness

Thursday July 13th, 2017

Ketoacidosis too often precedes diagnosis of diabetes in children, according to the findings of a major investigation published today.

The National Paediatric Diabetes Audit (NPDA) published by the Royal College of Paediatrics and Child Health (RCPCH) reveals one in four young people can develop Diabetic Ketoacidosis (DKA) before they are officially diagnosed with diabetes.

The audit shows that just over 5% of young people with a previous Type 1 diagnosis who were admitted to hospital in England and Wales had DKA.

Dr Justin Warner, RCPCH’s clinical lead for the NPDA and a consultant in paediatric endocrinology and diabetes, said: “It is crucial that all doctors are aware of the signs and symptoms of diabetes in children and young people and that greater public awareness is achieved.

"The earlier they are diagnosed, the less likely it is that they will develop DKA.

“In those already diagnosed with the condition, the management in childhood is a complex problem requiring close collaboration and partnership between the child, family and healthcare teams. It is disappointing to see no improvement in admission rates despite dramatic and continued overall improvement in diabetes care reported by the NPDA earlier this year.”

The report also highlights the importance of improving certain groups because, while overall admission rates have remained stable, rates are higher among females, teenagers and those living in areas of deprivation. There has been no overall improvement in rates achieved between 2012 and 2015.

The audit identified about 10,000 hospital admissions for diabetes-related complications per year in about 27,000 children and young people under the age of 25 with diabetes between for 2012 and 2015 who are cared for in 173 paediatric centres across England and Wales.

It also found that there had been no improvement in hospital admission rates for children and young people with other complications such as hypoglycaemia and that the risk of admission to hospital with DKA was higher among female adolescent children with longer disease duration and living in more deprived areas of the country.

The rate of inpatient admission of children with diabetes has remained constant over the past three years, unlike the outpatient audit which has shown improvement. Children presenting to hospital tended to be female, under four years of age, from deprived backgrounds, with poor diabetic control, and with longer duration of diabetes.

Dr Warner added: “The public and healthcare professionals who come into contact with children need to be more aware of the symptoms of diabetes, allowing earlier diagnosis and speedy treatment so as to avoid complications of DKA at diagnosis.

“A huge amount of work has been undertaken by healthcare teams, parents and patients to achieve better outcomes for children and young people in England and Wales over the last few years, which has been rewarded by continued improvements in national diabetes control.

“Similar energy and effort must now be directed towards reducing admission rates, which have not improved as might have been expected. Efforts to reduce admission rates should be tailored to those most at risk, including girls, those living in the most deprived areas, and those with poor diabetes control.”

Tags: Child Health | Diabetes | NHS | UK News

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