Diabetes: annual HbA1c (children T1DM)

Indicator type

Network / system level indicator. The indicator would be appropriate to understand and report on the performance of networks or systems of providers.

Rationale

This indicator aims to reduce the risk of complications associated with diabetes, and support early identification of any complications, in children and young people aged under 18 years, by monitoring glycated haemoglobin A1C (HbA1c). Good glycaemic control, measured using HbA1c, is important for the proactive management of diabetes to prevent complications, such as diabetic ketoacidosis.

Source guidance

Diabetes (type 1 and type 2) in children and young people: diagnosis and management. NICE guideline NG18 (2015, updated 2023), recommendation 1.2.79

Specification

Numerator: The number of people in the denominator who had their glycated haemoglobin A1c (HbA1c) monitored in the previous 12 months.

Denominator: The number of children and young people aged under 18 years with type 1 diabetes.

Calculation: Numerator divided by the denominator, multiplied by 100.

Exclusions: None

Personalised care adjustments or exception reporting should be considered to account for situations where the patient declines, does not attend or if HbA1c monitoring is not appropriate.

Data source: National Paediatrics Diabetes Audit.

Expected population size: The National Paediatric Diabetes Audit for 2023 to 2024 shows that 0.04% of people in England are aged under 18 years with type 1 diabetes: 4 per 10,000 patients served by a network. There is no minimum number of patients required for network level indicators. However, consideration should be given to whether the majority of results would require suppression because of small numbers.

ISBN: 978-1-4731-6949-4