title: The fifth UK paediatric diabetes services survey: meeting guidelines and recommendations?
abstract: OBJECTIVE
  To assess the provision of UK paediatric and adolescent diabetes services and examine changes in service delivery since 2002.
  
  
  METHODS
  Questionnaires were sent to the lead paediatric consultant from all paediatric and adolescent diabetes services (n=205). Questions were based on National Institute for Health and Clinical Excellence and Scottish Intercollegiate Guidelines recommendations for diabetes care in childhood. Results were analysed using parametric and non-parametric tests.
  
  
  RESULTS
  129 Services (63%) returned questionnaires involving 220 clinics. Staffing has improved and 98% of consultants have a special interest in diabetes (89%, 2002). In 88% of services, the diabetes specialist nurse worked solely in paediatric diabetes (53%, 2002). Only 21% of clinics have a psychological professional integrated within the diabetes team (20%, 2002). Over 94% of services offered support with intensive insulin regimens causing problems at school for 36% of services. Almost all services offer annual microvascular screening (98-100%) but transitional care was variable; only 76% of services have specific local protocols for transition and 21% organise transfer by letter only.
  
  
  CONCLUSIONS
  Paediatric and adolescent diabetes services are rising to the challenge of providing high-quality care despite rising prevalence and increasingly complex insulin regimes. Services have improved in a number of key areas but serious deficiencies remain.
authors.affiliation: Diabetes UK, Macleod House, 10 Parkway, London NW1 7AA, UK. charlotte.gosden@diabetes.org.uk
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gosden
authors.forename: Julie A
authors.initials: JA
authors.lastname: Edge
authors.forename: Richard I G
authors.initials: RI
authors.lastname: Holt
authors.forename: June
authors.initials: J
authors.lastname: James
authors.forename: Bridget
authors.initials: B
authors.lastname: Turner
authors.forename: Peter
authors.initials: P
authors.lastname: Winocour
authors.forename: Chris
authors.initials: C
authors.lastname: Walton
authors.forename: Dinesh
authors.initials: D
authors.lastname: Nagi
authors.forename: Rhys
authors.initials: R
authors.lastname: Williams
authors.forename: Krystyna
authors.initials: K
authors.lastname: Matyka
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration / Q000592:standards*; D002648:Child; D002662:Child Health Services / Q000458:organization & administration / Q000592:standards*; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards*; D048909:Diabetes Complications / Q000175:diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D010348:Patient Care Team / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D006113:United Kingdom
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin