Only a fifth of young adults aged 16 to 24 with diabetes receive the recommended care checks for their condition, according to research presented at the Diabetes UK Professional Conference 2012.
The study analysed data from the 2009–10 National Diabetes Audit (NDA) to identify that those aged 16 to 24 are the least likely of all age groups in England to receive the health checks and services they need. Only one in five young adults gets all the health processes recommended by the National Institute for Health and Clinical Excellence (NICE), including eye examinations and foot checks.
This poor management of diabetes in young adults increases the chance of life-threatening complications later in life: we are therefore urging the NHS to do more to stop young adults with diabetes falling through the gap between children’s and adult healthcare services.
"Huge emotional and financial cost"
Simon O’Neill, Director of Care, Policy and Intelligence at Diabetes UK, said, "It is crucial that young people with diabetes have access to all of the care checks they need to manage their condition properly, as this can help keep their diabetes under control and enable them to live long and healthy lives. But this study shows the quality of care for young adults is not good enough.
"There are likely to be a number of reasons for this, but one of them is that the change from children’s to adult services is currently not smooth enough. When the time comes to leave paediatric care, young people with diabetes should know exactly what to expect as they make that step. They need easy and convenient access to these services. Our 15 healthcare essentials, which outline the minimum healthcare services for people with diabetes, highlight the importance of this smooth transition. At the moment, we recognize that too many young people are falling off the radar in terms of diabetes care.
"By improving healthcare at this stage of life, the NHS can help prevent the huge emotional and financial cost of young people developing complications such as heart disease, stroke, kidney disease, blindness and amputation."
Poor control – and complications – common
Despite the widely held view that life-threatening complications only affect older people, these problems, often associated with poor diabetes control, are extremely common in a younger age group. Although under-55s make up around a quarter (24 per cent) of people with diabetes, the same demographic accounts for more than 60 per cent of End Stage Kidney Disease (ESKD) in those with Type 1 and 15 per cent of those with Type 2 diabetes. More than one in ten of all heart attacks and 15 per cent of major amputations in people with the condition occur in this same age group.
Poor diabetes control and management, often the cause of complications, was found to be common in this same age group. Data from the study show that adults under 55 years old are less likely to achieve their target blood glucose levels than older people, with only half of those with Type 2 diabetes achieving the average measurement of blood glucose (HbA1c) treatment target.
"Gap in care for young people"
Lead researcher Dr. Bob Young, from Salford Royal Hospital, said, "This study not only shows a gap in care for young people, but also highlights the negative outcomes this can have in the way of serious health problems. Care quality for younger people with Type 1 and Type 2 diabetes is poor. Systems of care for young and working age people with diabetes should be specifically targeted for improvement."
Through the 15 healthcare essentials campaign, Diabetes UK aims to empower people with diabetes to influence their own care and to influence the NHS to improve. We want people to use the checklist and, if there are any gaps in care, raise the issue with their healthcare team.