Paediatric diabetes: care and outcomes 2023/24 (NPDA)

Reports | Published: 13 Mar 2025

The National Paediatric Diabetes Audit (NPDA) has published a report on care and outcomes for the period 2023/24 in England and Wales.

Overall, the completion rate of health checks for Type 1 diabetes at all ages remains high, but there is considerable variation between PDUs ranging from 75% to 100%

This report finds a 16.5% overall increase in the numbers of children and young people (CYP) cared for by PDUs in England and Wales, however, the incidence of Type 1 diabetes decreased from 31.1 new cases per 100,000 in 2022/23 to 27.6 in 2023/24. This incidence rate is close to the levels observed prior to the COVID-19 pandemic. The national (England and Wales combined) median HbA1c for CYP with Type 1 diabetes has fallen to 60.0 mmol/mol. This is a 0.5 mmol/mol decrease from 60.5 mmol/mol in 2022/23 (HbA1C is a blood test that measures your average blood sugar level over the past 2 to 3 months. The better your blood glucose control, the less chance there is of developing diabetes related complications).

There were 1,359 children and young people being cared for in PDUs with Type 2 diabetes and, of these, there were 292 new cases – similar to the 268 new cases recorded in 2022/23. There has been a steady increase in this prevalence since the COVID-19 pandemic, from 790 in 2018/19 to 1,359 in 2023/24. This represents an increase of 72% over the last four years.

Recommendations include:

  • PDU workforce numbers should be mapped against the guidelines published by the National Children’s and Young People’s Diabetes Network in 2024 (NCYPDN)
  • The variation in outcomes by geography should be investigated and addressed to ensure equitable access and care
  • Studies should be funded to understand the progression from childhood signs of micro- and macro-vascular disease to the development of future diabetes complications, and to inform preventative interventions
  • Diabetes services should offer holistic multidisciplinary support to CYP with diabetes who are overweight or obese
  • CYP with Type 1 diabetes should have equitable access to diabetes-related technologies
  • Hybrid Closed Loop (HCL) systems should be offered to all eligible children in line with NICE Technology Appraisal guidance and implementation plans.

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Paediatric diabetes: care and outcomes 2023/24 (NPDA)