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
Background
Type 1 diabetes often starts in childhood. It is widely recognised that adolescence and young adulthood is a period during which delivery of routine care and achievement of treatment targets is least satisfactory.
- Diabetes is a very difficult condition to manage. From the point of diagnosis onwards, diabetes has a major impact on the life of a young person, placing an enormous 24/7 burden on them and their family or carers. Supporting lifelong management of the condition is essential in achieving the most positive outcomes for the individual.
- Adolescents making the transfer from childhood to adulthood are particularly at risk of disruption in care, with both short and long-term health effects. It is therefore very important that the handover of care from paediatric to adult services defends against this and does not intensify the risk.
- Care during this period needs collaborative support from medical, educational and psychological services. Engagement between paediatric and young adult services to provide continuity of care, and give young adults confidence to continue to manage their diabetes is pivotal. Falling short of this can lead to serious and lasting consequences, resulting in increased morbidity and mortality.
Adolescent and Young Adult Type 1 Diabetes cohort
A new diagnosis validation process* has been introduced to this report. Therefore the type 1 cohort used for this report will not be the same as the type 1 cohort used in previous National Diabetes Audit (NDA) reports. The cohort used for this report consists of people:
- Recorded as being diagnosed with type 1 diabetes within the 2017-18 to 2019-20 National Paediatric Diabetes Audit (NPDA) or 2017-18 to 2020-21 NDA core audits.
- Record of insulin treatment within audit year, either:
- Prescribed insulin treatment consistent with one of the regimens:
- Insulin pump**
- Basal-bolus
- Fixed mix.
- On insulin treatment according to a NPDA submission.
- On an insulin pump according to a NDA submission from a specialist service.
- Prescribed insulin treatment consistent with one of the regimens:
- Aged between 15 and 25 years at any point during the audit period (01 January 2017 to 31 March 2021).
57,060 people with type 1 diabetes were aged between 15 and 25 years old during the AYA period. A third were known to paediatric services (34.3%).
* This validation process should minimise the number of people with type 2 diabetes inadvertently coded as type 1, but may exclude a few frail type 1 individuals who are treated compassionately with very simple insulin regimens
** Insulin prescribed was Rapid Acting Insulin in a vial rather than insulin in cartridges or pre-filled pens.
National Diabetes Transition Audit (NDTA) becomes the AYA Type 1 Diabetes audit
The Adolescent and Young Adult Audit (AYA) was previously referred to as the NDTA, but has been renamed to AYA to reflect the change in approach to auditing care provision of young people with type 1 diabetes. The NDTA measured changes in glycaemic control and care provision across the period of transfer, looking only at people who had records of transfer from paediatric services to adult specialist services. However, AYA measures care provided and treatment outcomes across the age range 15 to 25 years, including everyone within this age range in NPDA and NDA during the AYA audit period. This approach aims to describe the trajectory of care, identify age groups which should be a priority for improvement, and create a framework for monitoring improvement action plans.
Last edited: 3 June 2024 10:34 am