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The health service is challenged with finding the best way of caring for increasing numbers of children and young people with diabetes with an increasingly intensive approach to their condition. Drawing on studies comparing outcomes across paediatric diabetes centres across the world, this paper examines what works best. Using the framework of the chronic care model, a theoretical best model of care is constructed from a combination of effective structures and processes of care. The model consists of patient-focused, goal- based care provided by a multidisciplinary team of skilled professionals. These local teams should be able to provide all aspects of diabetes care, from social and mental health care to the provision of accepted modern technologies, such as insulin pumps. Robust audit data need to be available from fully supported IT systems measuring structures, processes and outcomes of care. A central organisation such as a managed clinical network should exist to co-ordinate and supervise the delivery of this model in order to ensure equal delivery of high quality care for all.

The best model of care for children and young people with diabetes