Publication, Part of National Diabetes Audit: Adolescent and Young Adults with Type 1 Diabetes
Adolescent and Young Adult Type 1 Diabetes Audit (AYA), 2017-21
Future publication format
Please note that future publications will be web-based only. This is to improve the accessibility of our publications.
16 June 2022 09:30 AM
Change to inclusion of drug prescription and diabetic ketoacidosis (DKA) data for Wales
In the Interactive data visualisation published on 16 June 2022 Wales drug prescription data was not included in the diabetes diagnosis validation process. In v2.0 of the visualisation this data has been included resulting in a larger cohort used for the analysis, particularly for Wales. For further details on the diagnosis validation process see main report.
In addition, v2.0 no longer includes analysis on DKA hospital inpatient admissions for Wales. This is because it was only possible to obtain data NHS hospital admission data from hospitals in England and therefore any DKA hospital inpatient admission results for Wales would not have been representative of diabetes care in Wales.
18 July 2022 09:00 AM
Changes to NDA reporting
NHS England are currently reviewing the routine production of NDA State of the Nation reports. Please note that data will still be released via dashboards and standalone data files whilst this review is being conducted.
To help inform this review we would be grateful if users can provide feedback on their use of the State of the Nation reports using the feedback survey available in the ‘Related links' section of this page.
3 June 2024 00:00 AM
Care Processes
How many adolescents and young adults receive the care processes that are recommended to manage their type 1 diabetes?
Care processes - NICE (annual)
All people with diabetes aged 12 years and over should receive all of the 9 National Institute for Health and Care Excellence (NICE) recommended care processes and attend a structured education programme shortly after diagnosis. Due to differences in data collection and reporting between the National Diabetes Audit (NDA) and the National Paediatric Diabetes Audit (NPDA), the age ranges where care processes are treated as ‘should have occurred’ were consolidated and are shown against each care process below.
| Table 5: 9 annual care processes for people with type 1 diabetes | |
| Responsibility of Diabetes Care providers | |
| 1. HbA1c [All ages] | 5. Urine Albumin/Creatinine Ratio [Aged 12+] |
| (blood test for glucose control) | (urine test for risk of kidney disease) |
| 2. Blood Pressure [Aged 12+] | 6. Foot Risk Surveillance [Aged 12+] |
| (measurement for cardiovascular risk) | (examination for foot ulcer risk) |
| 3. Serum Cholesterol [All ages] | 7. Body Mass Index [All Ages] |
| (blood test for cardiovascular risk) | (measurement for cardiovascular risk) |
| 4. Serum Creatinine [Aged 19+] | 8. Smoking History [Aged 19+] |
| (blood test for kidney function) | (question for cardiovascular risk) |
| Responsibility of NHS Diabetes Eye Screening (NHS England) | |
| 9. Digital Retinal Screening [Aged 12+] | |
| (photographic eye test for early detection of eye disease) | |
Please note cholesterol is not a mandated care process for adolescents and young adults. Thyroid checks are a mandatory care process for adolescent and young adults. However as the NDA does not collect this data this care process is not assessed in this report.
Due to retinal screening data only being available from 2019-20 and due to serum creatinine and smoking checks not being included in the NPDA, this report is restricted to 6 of the 9 care processes for England.
- For the majority of care processes, the highest completion rate occurred at ages 16 and 17 years and the lowest rates occurred at age 19 and 20.
- Completion rates tended to be consistent from 21 years old onwards.
- The completion rate of cholesterol care process increased with age. However this is most likely due to the measuring of cholesterol not being mandatory in paediatric services.
* Due to retinal screening data only being available from 2019-20 and due to serum creatinine and smoking checks not being included in the NPDA, this report is restricted to 6 of the 9 care processes for England.
** Under 12s: HbA1c, BMI and cholesterol care processes.
12-18 years: HbA1c, BMI, cholesterol, blood pressure, urine albumin, retinal screening and foot exam care processes.
19 years and over: HbA1c, BMI, cholesterol, blood pressure, urine albumin, retinal screening, foot exam, smoking status and creatinine care processes.
*** Cholesterol is not a mandated care process for adolescents and young adults.
**** For a table of the underlying percentages see Appendix.
***** For individual charts on HbA1c, Urine Albumin Creatinine Ratio (UACR) and blood pressure care process completion rates see Appendix.
- The highest completion rates for all 6 care processes were found in adolescents and young adults with type 1 diabetes aged 15 to 17 years.
- This dropped at 18 years old and then again at 19 years old where the lowest completion rate was found.
- The completion rate steadily rose from the age of 20 years, but did not reach the percentages found in younger age groups
* Due to retinal screening data only being available from 2019-20 and due to serum creatinine and smoking checks not being included in the NPDA, this report is restricted to 6 of the 9 care processes for England.
** Under 12s: HbA1c, BMI and cholesterol care processes.
12-18 years: HbA1c, BMI, cholesterol, blood pressure, urine albumin, retinal screening and foot exam care processes.
19 years and over: HbA1c, BMI, cholesterol, blood pressure, urine albumin, retinal screening, foot exam, smoking status and creatinine care processes.
*** Cholesterol is not a mandated care process for adolescents and young adults.
Last edited: 3 June 2024 10:34 am