National First Year of Care (FYOC) Pathway – Type 1 Diabetes
The first year following a diagnosis of type 1 diabetes is one of the most important periods in a child or young person’s diabetes journey. Research has shown that glycaemic control achieved during the first year is associated with future diabetes outcomes, with early HbA1c linked to the risk of long-term microvascular complications. Studies have also demonstrated that HbA1c typically reaches its lowest point within the first 3–6 months after diagnosis before beginning to rise, highlighting the importance of providing structured support throughout the first year.
The National First Year of Care (FYOC) Pathway was developed by a multidisciplinary national working group to provide a consistent, evidence-based approach to care for children and young people across England. The pathway supports diabetes teams to deliver high-quality, person-centred care during the first 12 months following diagnosis, helping children, young people and their families build the knowledge, skills and confidence needed to manage diabetes.
A national pilot involving six paediatric diabetes units demonstrated that implementation of the pathway improved clinical outcomes, including increasing the proportion of children achieving an HbA1c below 48 mmol/mol from 27% to 36% at 4–6 months and from 25% to 37% at 9–12 months, alongside an increase in the proportion achieving Time in Range >70% at 12 months from 32% to 41%.
The pathway has now been adopted nationally. On this page you can access the pathway, supporting resources and implementation materials to help deliver high-quality First Year of Care for every child and young person diagnosed with type 1 diabetes.
First Year of Care Pathway – Final_National FYOC Timeline 2024
ISPAD Poster – P38 FYOC ISPAD 2025 poster V2