NPDA 2019-20 Appendix 2: Data completeness
Source: data.gov.uk (2024-05-31)

National Paediatric Diabetes Audit 2019 - 2020. National Paediatric Diabetes Audit 2019 - 2020

The excel file contains unit, regional and national level data obtained from the National Paediatric Diabetes Audit 2019-2020.
Specifically, it includes information on patient characteristics, completion of health checks and outcomes achieved (as recommended by the National Institute for Clinical Excellence) for infants, children and young people with type 1 diabetes, under the age of 25, who attended paediatric diabetes units in England and Wales between 1 April 2019 and the 31 March 2020.
Data are included for the seven key health checks:
• Glycated Haemoglobin A1c (HbA1c)
• Body Mass Index (BMI)
• Thyroid
• Blood pressure
• Urinary albumin
• Foot examination
• Eye screening.

Data on other health checks include:
• Psychological assessment
• Offering of immunisation against influenza
• Advice about managing diabetes (‘sick-day rules’)
• Using (or trained to use) blood ketone testing strips and a meter
• Cholesterol
• Additional dietetic support

Data are included for health checks at diagnosis
• Screening for autoimmune disease (coeliac and thyroid disease) 
• Provision of Level 3 carbohydrate-counting education

Data on outcomes of care include:
• HbA1c target measurements
• Small vessel (microvascular) disease
• Large vessel (macrovascular) disease
• Autoimmune disease (coeliac and thyroid disease)

The data were first published in 2021 alongside the National Paediatric Diabetes Audit Report 2019-2020 Data suppressed due to small numbers (<5).

For further information and details on the audit please refer to:
• National Paediatric Diabetes Audit Annual Reports: https://www.rcpch.ac.uk/resources/npda-annual-reports
• NPDA results online: http://npda-results.rcpch.ac.uk/default.aspx
• The RCPCH website: https://www.rcpch.ac.uk/npda

1

Appendix 2
Data completeness and statistical representativeness of
the 2019/20 audit

One hundred and sixty-six PDUs from a total of 173 (96.0%) across England and Wales,
submitted information to the 2019/20 audit. Table 1 shows five regional networks with
100% participation.
Table 1: Number of PDUs participating in the 2019/20 audit, by country and regional network.

PDUs in 2019/20

Total PDUs (N)
Participation
(n)
Participation (%)
England and Wales
173
166
96.0
England
161
154
95.7
Wales
12
12
100.0

East Midlands
10
10
100.0
East of England
17
16
94.1
London and South East
38
36
94.7
North East and North Cumbria
13
13
100.0
North West
20
19
95.0
South Central
16
16
100.0
South West
11
10
90.9
West Midlands
19
19
100.0
Yorkshire and Humber
17
15
88.2

Table 2 shows that the units participating in the 2019/20 audit account for more than 95%
of the population of children and young people with diabetes in all the regions and overall,
when considering the data submitted to the audit in 2018/19. The table also shows that
the number of children submitted by the participating units increased 1.1% with respect to
2018/19 (column E), and the overall reduction in the number of children included in the
audit was 3% (column F).
Table 2: Variation in the number of children and young people included in the audit, all types of
diabetes, by country and regional network

2018/19
2019/20
Total
CYP
Number of
CYP in
participating
units
Proportion
(%)
Total CYP
submitted
to the
audit
% variation
within
participating
units
compared to
2018/19
% total
variation
compared
to
2018/19
England and
Wales
30,155
28,920
95.9
29,242
 1.1
 (-3.0)
England
28,676
27,441
95.7
27,780
 1.2
 (-3.1)
Wales
1,479
1,479
100.0
1,462
 (-1.2)
 (-1.2)

East Midlands
2,038
2,038
100.0
2,021
 (-0.8)
 (-0.8)
East of England
3,231
2,990
92.5
3,067
 2.6
 (-5.1)

2

London and
South East
6,732 *
6,293
93.5
6,487
 3.1
 (-3.6)
North East and
North Cumbria
1,650
1,650
100.0
1,668
 1.1
 1.1
North West
3,756
3,649
97.2
3,679
 0.8
 (-2.1)
South Central
2,738 *
2,738
100.0
2,731
 (-0.3)
 (-0.3)
South West
2,385
2,149
90.1
2,133
 (-0.7)
 (-10.6)
West Midlands
3,206
3,206
100.0
3,253
 1.5
 1.5
Yorkshire and
Humber
2,940
2,728
92.8
2,741
 0.5
 (-6.8)
* Totals and variation reported for South Central and London and South East reflect the transition
of two units (Worthing Hospital and St Richard’s Chichester) from the London and South East
network to the South Central network in 2019/20.

Type 1 diabetes
Comparison of the demographic characteristics of the children and young people with
type 1 diabetes included in the 2019/20 audit and 2018/19 audit is presented in Table 3. The
table shows that the units participating in the 2019/20 audit and those who did not had
a similar demographic composition in terms of age groups, diabetes duration and gender,
but were different in terms of ethnicity and deprivation.
Table 3: Characteristics of children and young people with Type 1 diabetes included in the 2018/19
and 2019/20 NPDA
Type 1 diabetes
2019/20
2018/19
All
Participating
units
Non-
participating
units in
2019/20
Pearson
Chi-square
test of
significance
Number of children and
young people
27,653
28,597
27,453
1,144

Age groups (%)
0-4 years old
5.2
5.4
5.4
5.1
Pearson
chi2(3)
Pr = 0.752
5-9 years old
21.4
21.7
21.6
22.8
10-14 years old
42.3
41.3
41.4
40.5
15+ years old
31.1
31.6
31.6
31.6
missing
0.0
0.0
0.0
0.0
Diabetes duration (%)
Less than 1 year
21.2
20.8
20.8
21.1
Pearson
chi2(6)
Pr = 0.178
1-2 years
21.0
21.5
21.6
20.7
3-4 years
18.1
17.6
17.5
19.1
5-9 years
28.3
28.1
28.2
25.9
10-14 years
10.1
10.5
10.5
11.0
15+ years
1.2
1.3
1.2
2.2 +
missing
0.1
0.2
0.2
*
Gender (%)
Boys
52.2
52.0
52.1
49.7
Pearson
chi2(3)
Pr = 0.149
Girls
47.6
47.8
47.7
50.3
Not specified/unknown
0.2
0.2
0.2
0.0
missing
0.0
0.0
0.0
0.0

3

Ethnicity (%)
White
80.1
79.5
79.8
72.8
Pearson
chi2(6)
Pr = 0.000
Asian
6.2
6.3
6.2
8.7
Black
3.8
3.7
3.5
7.4
Mixed
3.1
2.9
2.9
2.5
Other
2.0
1.9
1.7
4.9
Not stated/unknown
4.8
5.6
5.7
3.4
missing
0.0
0.2
0.2
0.4
Deprivation (%)
Most deprived
23.0
22.6
22.9
14.8
Pearson
chi2(5)
Pr = 0.000
Second most deprived
20.2
19.9
19.9
20.0
Third least deprived
19.1
19.0
18.9
21.2
Second least deprived
18.6
19.2
19.0
22.9
Least deprived
19.0
19.2
19.2
20.7
missing
0.1
0.2
0.2
0.4
* indicates a number less than 5 which has been suppressed
+ results merged to mask a number <5

Table 4 shows that in 2018/19 there were not significant differences between the HbA1c
outcomes of the children and young people within the participating units and the no-
participating units. On the other hand, there was a significant difference in terms of the
completion rates of key health checks and the proportion of young people receiving all
seven key health checks.
Table 4: Outcome differences between participating and no-participating units, 2018/19 audit

2018/19 audit
whole
sample
Participating
units
Non-
participating
units
test
Children and young people with all types of diabetes

n
28,277
27,170
1,107
-
Mean HbA1c (mmol/mol)
64.6
64.5
65.2
t-test
Pr >0.05
Median HbA1c (mmol/mol)
61.5
61.5
61.5
Pearson chi2(1)
Pr = 0.968
Children and young people with Type 1 diabetes
n
26,987
25,944
1,043
-
Mean HbA1c (mmol/mol)
65.0
65.0
65.5
t-test
Pr > 0.05
Median (mmol/mol)
62.0
62.0
62.0
Pearson chi2(1)
Pr = 0.676
n (12+ years old and complete
year of care)
13,391
12,838
553
-
Health-checks completion rate
88.5
88.7
84.0
Mann-Whitney
Pr =0.000
Pearson chi2(7)

4

Pr =0.000
% of CYP receiving all 7
recommended health-checks
55.2
55.5
47.4
Two-sample test
of proportions
Pr <0.05

Linear regression was performed to establish whether the case mix within units who
participated in the 2019/20 audit was different in terms of their HbA1c outcomes
compared to those who did not participate. Table 5 shows how the case-mix adjustment
for mean HbA1c in 2018/19 if using only data from the participating units (column B) or the
no-participating units (column C). There is only a statistically significant change across the
three groups when considering (𝛼= 0.05 ), with the difference between boys and girls
being smaller in the group of participating units and larger in the group of non-
participating units.
Table 5: Case-mix regression results for three groups in 2018/19: Whole sample, units participating
in 2019/20, and units not participating in the 2019/20 NPDA
2018/19

(A)
(B)
(C)
(D)
Type 1
diabetes
Linear regression
(HbA1c mmol/mol)
whole sample
(n = 26,900)
Linear regression
(HbA1c mmol/mol)
participating units in
2019/20
(n = 25,864)
Linear regression
(HbA1c mmol/mol)
Non-participating units
in 2019/20
(n = 1,036)
Chi-squared
(P-value)
Coefficient
P-
value
Coefficient
P-
value
Coefficient
P-
value
Boys (cf girls)
-0.84
(-1.21 to -0.47)
0.000
-0.76
(-1.14 to -0.37)
0.000
-2.81
(-4.77 to -0.86)
0.005
A-B (0.029)
A-C (0.042)
B-C (0.042)
Age
(in whole years)
0.95
(0.89 to 1.00)
0.000
0.94
(0.89 to 1.00)
0.000
1.10
(0.83 to 1.39)
0.000
A-B (0.357)
A-C (0.271)
B-C (0.273)
Duration
(in whole years)
0.61
(0.55 to 0.67)
0.000
0.62
(0.55 to 0.68)
0.000
0.46
(0.19 to 0.73)
0.001
A-B (0.368)
A-C (0.294)
B-C (0.296)
Ethnic group (cf White)

Asian
0.61
(-0.17 to 1.38)
0.124
0.44
(-0.34 to 1.23)
0.267
4.18
(0.51 to 7.85)
0.036
A-B (0.108)
A-C (0.065)
B-C (0.067)
Black
4.59
(3.39 to 5.79)
0.000
4.29
(3.06 to 5.51)
0.000
8.30
(3.02 to 13.6)
0.002
A-B (0.126)
A-C (0.150)
B-C (0.150)
Mixed
2.90
(1.70 to 4.10)
0.000
2.71
(1.51 to 3.92)
0.000
8.30
(-0.04 to 16.6)
0.051
A-B (0.204)
A-C (0.194)
B-C (0.194)
Other
-1.23
(-2.64 to 0.19)
0.089
-1.68
(-3.17 to -0.19)
0.027
2.80
(-1.68 to 7.27)
0.221
A-B (0.060)
A-C (0.065)
B-C (0.063)

5

Not stated or
unknown
0.21
(-0.63 to 1.05)
0.617
0.10
(-0.75 to 0.95)
0.826
4.42
(-1.04 to 9.88)
0.113
A-B (0.071)
A-C (0.127)
B-C (0.125)
Deprivation (cf most deprived)

Second most
deprived
-2.07
(-2.68 to -1.45)
0.000
-2.00
(-2.63 to -1.37)
0.000
-5.09
(-8.86 to -1.33)
0.008
A-B (0.285)
A-C (0.109)
B-C (0.112)
Third least
deprived
-3.41
(-4.02 to -2.79)
0.000
-3.30
(-3.92 to -2.68)
0.000
-7.42
(-11.10 to -3.74)
0.000
A-B (0.100)
A-C (0.300)
B-C (0.031)
Second least
deprived
-5.07
(-5.67 to -4.47)
0.000
-5.03
(-5.64 to -4.42)
0.000
-7.81
(-11.46 to -4.17)
0.000
A-B (0.495)
A-C (0.134)
B-C (0.140)
Least
deprived
-6.64
(-7.23 to -6.05)
0.000
-6.56
(-7.16 to -5.96)
0.000
-9.85
(-13.36 to -6.33)
0.000
A-B (0.161)
A-C (0.070)
B-C (0.071)
Constant
54.43
(53.78 to 55.08)
0.000
54.39
(53.73 to 55.05)
0.000
56.49
(52.77 to 60.22)
0.000
A-B (0.571)
A-C (0.268)
B-C (0.276)

Type 2 diabetes
Comparison of the demographic characteristics of the children and young people with
type 2 diabetes included in the 2019/20 audit and 2018/19 audit is presented in Table 6.
The table shows that similarly to comparison of those with type 1 diabetes, the units
participating in the 2019/20 audit and those who did not had a similar demographic
composition in terms of age groups, diabetes duration and gender, but were different in
terms of ethnicity and deprivation.

Table 6: Characteristics of children and young people with Type 2 diabetes
Type 2 diabetes
2019/20
2018/19
All
Participating
units
No-
participating
units
Test
Number of children and
young people
866
790
753
37

Age groups (%)
0-4 years old
0.0
0.0
0.0
0.0
Pearson
chi2(2)
Pr= 0.452
5-9 years old
2.5
2.4
2.4
*
10-14 years old
38.8
39.6
40.1
32.4 +
15+ years old
58.7
58.0
57.5
67.6
missing
0.0
0.0
0.0
0.0
Diabetes duration (%)
Less than 1 year
45.5
45.2
44.9
51.4
Pearson
chi2(5)
1-2 years
31.0
34.9
35.6
21.6

6

3-4 years
16.1
12.7
12.4
27.0 +
Pr= 0.440
5-9 years
5.2
5.3
5.2
*
10-14 years
1.0
0.4
*
0.0
15+ years
0.1
0.0
0.0
0.0
missing
1.2
1.5
2.0 +
0.0
Gender (%)
Boys
35.5
31.4
31.5
29.7
Pearson
chi2(2)
Pr= 0.902
Girls
64.3
68.2
68.5 +
70.3
Not specified/unknown
0.2
0.4
*
0.0
missing
0.0
0.0
0.0
0.0
Ethnicity (%)
White
33.1
36.8
36.9
35.1
Pearson
chi2(6)
Pr= 0.023
Asian
35.7
35.6
35.9
29.7
Black
13.6
10.6
10.0
35.2 +
Mixed
5.8
5.3
5.2
*
Other
3.8
3.0
3.2
0.0
Not stated/unknown
8.0
8.0
8.9
0.0
missing
0.0
0.6
*
*
Deprivation (%)
Most deprived
45.5
45.7
47.1
16.2
Pearson
chi2(5)
Pr= 0.008
Second most deprived
26.7
26.3
25.9
35.1
Third least deprived
14.7
14.3
13.9
21.6
Second least deprived
8.2
8.6
8.1
27.1
Least deprived
4.6
4.8
4.7
*
missing
0.4
0.3
0.3
0.0
* indicates a number less than 5 which has been suppressed
+ results merged to mask number <5

Table 7 shows that in 2018/19 the median HbA1c amongst children and young people with
type 2 diabetes was not significantly different between PDUs who did or did not
participate in the 2019/20, however the mean HbA1c for non-participating units was
significantly higher. Completion rates of key health checks and the proportion of young
people receiving all seven key health checks were also significantly lower for children and
young people with type 2 diabetes in the PDUs who did not participate in 2019/20.

7

Table 7: Outcome differences between participating and no-participating units, 2018/19 audit

2018/19 audit
whole
sample
Participating
units
No-
participating
units
test
Children and young people with Type 2 diabetes
n
674
645
29
-
Mean HbA1c (mmol/mol)
57.4
56.9
68.3
t-test
Pr < 0.05
Median (mmol/mol)
49.5
49.5
61.5
Chi-squared
Pr >0.05
n (12+ years old and complete
year of care)
470
451
19
-
Health-checks completion rate
77.7
78.6
57.1
Mann-Whitney
Pr <0.05
Chi-squared
Pr <0.05
% of CYP receiving all 7
recommended health checks
30.9
31.9
5.3
Two-sample test
of proportions
Pr <0.05