Quality statement 2: Education and information

Quality statement

Children and young people with type 1 or type 2 diabetes are offered a programme of diabetes education from diagnosis that is updated at least annually.

Rationale

Education is essential in enabling self-management of diabetes and reducing the chance of complications. It should start at diagnosis and continue throughout a person's life. It is important to focus education on core topics and tailor it to the individual needs and learning styles of the child or young person and their family members or carers (as appropriate).

Quality measures

Structure

a) Evidence of local arrangements and written protocols to ensure that children and young people with type 1 diabetes are offered a programme of diabetes education from diagnosis that is updated at least annually.

Data source: Local data collection and 2013–14 National Paediatric Diabetes Audit.

b) Evidence of local arrangements and written protocols to ensure that children and young people with type 2 diabetes are offered a programme of diabetes education from diagnosis that is updated at least annually.

Data source: Local data collection and 2013–14 National Paediatric Diabetes Audit.

Process

a) Proportion of children and young people with type 1 diabetes who are offered a programme of diabetes education from diagnosis that is updated at least annually.

Numerator – the number in the denominator who receive a programme of diabetes education from diagnosis that is updated at least annually.

Denominator – the number of children and young people with type 1 diabetes.

Data source: Local data collection and 2013–14 National Paediatric Diabetes Audit.

b) Proportion of children and young people with type 2 diabetes who are offered a programme of diabetes education from diagnosis that is updated at least annually.

Numerator – the number in the denominator who receive a programme of diabetes education from diagnosis that is updated at least annually.

Denominator – the number of children and young people with type 2 diabetes.

Data source: Local data collection and 2013–14 National Paediatric Diabetes Audit.

Outcome

a) Quality of life.

Data source: Local data collection.

b) HbA1c level of 48 mmol/mol or lower.

Data source: Local data collection and 2013–14 National Paediatric Diabetes Audit.

c) Satisfaction of children, young people and their family members or carers (as appropriate) with the education intervention.

Data source: Local data collection and 2013–14 National Paediatric Diabetes Audit.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (secondary care diabetes services for children and young people) ensure that systems are in place to offer children and young people with type 1 or type 2 diabetes and their family members or carers (as appropriate) a programme of diabetes education from diagnosis that is tailored to their individual needs and learning styles and updated at least annually.

Healthcare professionals (such as those providing diabetes services for children and young people) offer children and young people with type 1 or type 2 diabetes and their family members or carers (as appropriate) a programme of diabetes education from diagnosis that is tailored to their individual needs and learning styles and updated at least annually.

Commissioners (NHS England regional teams and clinical commissioning groups) commission services that offer children and young people with type 1 or type 2 diabetes and their family members or carers (as appropriate) a programme of diabetes education from diagnosis that is updated at least annually.

What the quality statement means for children and young people and their parents and carers

Children and young people with type 1 or type 2 diabetes and their family members or carers are offered a programme of diabetes education when they are diagnosed with diabetes. This education should continue throughout their life, and be updated every year.

The programme should teach them what they need to know about their condition and what changes they might need to make now that they have diabetes. This includes clear advice (designed specifically for each child or young person) on what to do when they are ill or have high blood glucose levels.

Source guidance

Definitions of terms used in this quality statement

Programme of diabetes education (type 1 diabetes)

A continuing programme of education that is age appropriate, tailored to need and revisited at least annually. The following core topics should be included from diagnosis:

  • insulin therapy, including its aims, how it works, its mode of delivery and dosage adjustment

  • blood glucose monitoring, including targets for blood glucose control (blood glucose and HbA1c levels)

  • the effects of diet, physical activity and intercurrent illness on blood glucose control

  • managing intercurrent illness ('sick‑day rules', including monitoring of blood ketones [beta‑hydroxybutyrate])

  • detecting and managing hypoglycaemia, hyperglycaemia and ketosis.

[Adapted from Diabetes (type 1 and type 2) in children and young people: diagnosis and management (2015) NICE guideline NG18, recommendation 1.2.1 and expert opinion]

Programme of diabetes education (type 2 diabetes)

A continuing programme of education that is age appropriate, tailored to need and revisited at least annually. The following core topics should be included from diagnosis:

  • HbA1c monitoring and targets

  • the effects of diet, physical activity, body weight and intercurrent illness on blood glucose control

  • the aims of metformin therapy and possible adverse effects

  • the complications of type 2 diabetes and how to prevent them.

[Adapted from Diabetes (type 1 and type 2) in children and young people: diagnosis and management (2015) NICE guideline NG18, recommendation 1.3.1 and expert opinion]

Equality and diversity considerations

Particular care should be taken when communicating with children and young people with type 1 or type 2 diabetes and their family members or carers (as appropriate) if they have, for example:

  • physical, cognitive or sensory disabilities

  • difficulties speaking or reading English.