Children with diabetes missing out on key health checks

Nurses urged to encourage greater uptake of vital screening

Almost three in four children with type 1 diabetes are not having vital annual health checks, research suggests.

Only 25.4% of 12-year-olds received all seven of the recommended healthcare checks, says a survey. A total of 27,682 children and young people with diabetes attending paediatric diabetes units during 2014/15 in England and Wales took part in the survey.

However, the National Paediatric Diabetes Audit (NPDA), published today by the Royal College of Paediatrics and Child Health, also shows the number of children achieving 'excellent diabetes control' has increased from 15.8% in 2012/13 to 23.5% in 2014/15.

St Helen and Knowsley Teaching Hospitals NHS Trust paediatric diabetes specialist nurse Helen Thornton acknowledged the health check figures were a concern, but cautioned that the low numbers could be explained by a lack of data recording.

'The audit figures only show what is being recorded. Health checks could be being carried out by teams, but not recorded', said Ms Thornton, who sat on the NPDA project board. 'The good news is that, overall, diabetes control is improving in this country.'

Family support

Ms Thornton said there was a need to make sure families accessed health care and understood the importance of it. 'Nurses have a key role, because we are often supporting families to attend checks and looking at barriers to attendance,' she said. 'Nurses can drive change, it does not have to come from our medical colleagues.' 

NICE states every child with diabetes should have average blood glucose level (HbA1C) checked, while those over the age of 12 should have the following six other annual health checks:

•    Growth
•    Blood pressure
•    Kidney function
•    Cholesterol
•    Eye screening
•    Foot examination

Screening for complications

The NPDA findings also showed almost half (43%) of children did not receive psychological assessments, and at least one third were not being screened for thyroid and coeliac disease.

NPDA clinical lead Justin Warner said the health checks formed part of a lifetime of screening for complications. Early intervention could reduce disease progression, he emphasised.

Dr Warner said: 'More children from this audit could have all seven care processes completed – service providers simply might not be writing the information down. This could be for a number of reasons, including a lack of time and resources. However, not doing so makes it harder to monitor and improve services and communicate efficiently with patients, their family and different healthcare professionals.'

Further information:

National Paediatric Diabetes Audit