Diabetes Obes Metab. 2025 Jan 7. doi: 10.1111/dom.16140. Online ahead of print.
ABSTRACT
BACKGROUND: Transition from paediatric to adult healthcare is a turning point for patients with Type 1 diabetes (T1D). A gradual coordinated process connecting paediatric and adult healthcare providers may improve adherence to adult follow-up.
AIMS: To describe a transition process developed jointly by paediatric and adult diabetology units and compare patients progressing or not to follow-up in adult care setting.
MATERIEL AND METHODS: Retrospective study in one paediatric and one adult diabetology department. Patients following from 2014 to 2021 in the paediatric department were eligible.
RESULTS: At transition, the 183 patients included had a median age of 19 [18.5-19.5] years, T1D duration of 10.5 [7.0-14.0] years, and HbA1c of 8.4% [7.5-9.2%]; 30.6% were treated by continuous subcutaneous insulin infusion. Two years after exiting paediatric care, the subgroup transitioning to adult care at the planned site (n = 137) had a median HbA1c of 7.8% [7.0-8.7]; 13.1% had retinopathy (non-significant change), and 10.8% had changed their insulin treatment. Of the remaining 46/183 (25.1%) patients, 33/46 (71.7%) had no adult care visits at any site reported. Independent predictors of non-adherence to adult follow-up were younger age at TID diagnosis (adjusted odds ratio, 0.91 [0.83-0.99]) and higher pre-transition HbA1c (+1.39 [1.11-1.80]). Among the 52 (28.4%) patients who completed a questionnaire on perceptions, 88.5% reported being well prepared and 90.5% a neutral or positive impact on their diabetes.
CONCLUSION: With a gradual coordinated transition process, most T1D patients attended adult care follow-up visits. Younger age at diagnosis and worse glycaemic control were associated with lack of adherence to planned adult care follow-up.
PMID:39764706 | DOI:10.1111/dom.16140
