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New tool to improve health outcomes for younger people with diabetes

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Diabetes UK has welcomed the launch of a new specification for NHS services for young people with diabetes who are moving from children’s to adult services. Improving services for young people is vitally important as they are around five times more likely to die than other young people without diabetes.

The NHS England Diabetes Transition Service Specification, is the first agreed set of principles from NHS England for the care of younger people with diabetes. It is designed for those who are transitioning from a paediatric service to an adult service. It is also intended to work for younger people moving between different adult services, including to primary care settings, and younger people moving from one area to another.

Importance of designing better systems of care

Evidence suggests that many younger people lose engagement with their diabetes services when they are transitioning. Given the drastic consequences of disability and premature mortality in middle life if care and treatment is not adequate, designing better systems of care for younger people has the potential to yield considerable benefits.

Diabetes UK has long argued that more needs to be done to help younger people manage their diabetes better, especially when they are transitioning services. The specification came as a result of a number of issues including large variation of care, poor target adherence, poor outcomes and higher mortality for younger people.

HbA1c is the most basic check in diabetes care for how the condition is being managed. Data from the National Paediatric Diabetes Audit shows that between 90-92 per cent of under 14s have their HbA1c measured each year, but this falls to 53-56 per cent of 20-24 year olds.

Increased risk of mortality for younger people

There is also a far greater relative risk of death at younger ages. There is a seven fold increased risk of death in young women with diabetes and four fold increased risk of young men with diabetes, between the ages of 15-34.

Younger people were consulted and were able to comment on early drafts of the specification to ensure their voice was heard.

Bridget Turner, Director of Policy and Care Improvement, said: “This specification has been eagerly awaited by healthcare professionals. At the moment we know that far too many young people are falling through the cracks of diabetes care when it comes to transition. This gives commissioners the tools to help them develop effective transition and young adult services. We are urging Clinical Commissioning Groups to work with paediatric and adult diabetes specialist teams to put the good care into practice and reap the benefits of better long-term health outcomes for younger people with Type 1 diabetes.

Services need to work with younger people

“What these services need to do is work with younger people to enable them to get the best out of what’s on offer. For example talking about how they want to communicate with their healthcare team and whether perhaps Skype or e-mail is more useful to them in some instances. Or other ways of making services more accessible, such as evening and/or Saturday morning clinics.

“We want to see the specification adopted and used to bring about better care for younger people as younger people with diabetes grow up. This transitionary process of moving care between different organisations is an important stage in their lives to get right. We look forward to seeing how the NHS uses this tool and how younger with diabetes people benefit from this new approach.”

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