When I was a child, I remember having several check-ups every time I’d attend my diabetes appointments. After my diagnosis my check-ups were every 3 months and then it became every 6 months. These checks covered everything from, cholesterol testing, blood tests, feet check-up. Both of these tests would also be checked at my GP surgery once a year. My eyes were tested at my opticians, annually.
Nevertheless all the results from these check-ups would then be sent over to my consultant at my diabetes clinic. Every appointment the doctor would have the most recent results from these check-ups. Appointments moved swiftly and results were explained in as much or as little detail needed. Any concerns or advice were given and time for listening was also given. Everything was in order and none of my check-up were ever missed.
However, a recent study of children ages 12 to 24 with diabetes, attending paediatric diabetes units in England and Wales proposed that, nearly 75 % of these children are not getting the necessary health checks.
70 % of these children are in fact type 1 diabetics, who are insulin dependent and require these check-ups to be carried out at least annually, routinely and efficiently.
From the study, data was collected from 27, 682 children and young people, which outlined that only 25.4 % of these children (ages 12 to 24) were having the seven recommended annual checks.
“Guideline from NICE (The National Institute For Health and Care Excellence) state all children with diabetes should have their blood sugar levels checked every year and those over the age of 12 should also have six other health checks.”
These checks for this age group should include:
- Measurement of growth
- Blood pressure
- Thorough eye tests, examining the backs of the eyes in detail
- Cholesterol testing
- Feet check-ups
- Kidney function
The study also found that, from this age group (children age 12 to 24 years old), those who were considered to have “excellent diabetes control” of 7.5mmol/l, had in fact risen to 15.8mmol/l in 2012 and then by 2014 -15 this had risen even further to 23.5%.
These results are extremely disturbing and it clearly shows that there is a failure within the basic support and care of children and young people living with diabetes. These check-ups should be routine and frequent enough so that both the patient and the doctor are aware of the patients diabetes management.
As alarming as these results are, the report carried out also showed that at least 98.7% of these children in this age group had their HbA1c tested. However, only 23 % had started to increase their chances of not developing complications due to poorly managed diabetes.
On the other hand, the most frequently missed checks amongst children age 12-24, involved foot examination, eye screening and cholesterol testing. All these tests are crucial when it comes to managing diabetes treatment and the regularity of these tests being done will only aid in the detection of any signs of diabetes complications or any damage being done to organs. Detecting signs for complications such as (blindness and kidney damage) early could potentially help to avoid or lessen the effects of the complication and if treatment is necessary then it can be administered at an early stage.
The study also showed that children from poorer areas were found to have worst HbA1c test results whilst children in more prosperous areas were found to have better HbA1c results.
Bridget Turner, director of policy and care improvement at Diabetes UK, said, “There remains considerable variation in the level of care provided. This is very worrying because if children and young people are not supported to manage their diabetes well in early life, they are more likely to be at risk of debilitating and life threatening complications in adult life such as amputations, blindness and stroke.”
Since the report, The NHS (National Health Service) are working to improve the delivery of effective integrated diabetes services with the help of clinical commissioning groups across Wales and England.
I hope that future reports will show that children within this age group suffering with diabetes are being taken care of and not going without these fundamental check-ups, regardless of their economical status.