Transition From Childhood to Adult Care in Patients with Type 1 Diabetes: 20 Years of Experience From the Tübinger Transition Study.

Abstract

AIMS:

Transition from pediatric to adult care is difficult for patients with chronic diseases. In this study, factors associated with metabolic control in childhood-onset type 1 diabetes (T1D) after transfer to adult care were analyzed.

METHODS:

Overall, 224 persons with T1D were contacted yearly from 1998 to 2019. They voluntarily answered a questionnaire about their current hemoglobin A1c (HbA1c) levels, diabetes-associated complications, kind of care, living conditions, and family situation. Then, mixed longitudinal-cross-sectional analyses were carried out.

RESULTS:

Overall, 190 patients answered at least once (mean age: 26.6 years). Diabetes complications were mentioned by 10 patients (5 microalbuminuria, 5 retinopathy). Most patients (92.6%) were in diabetes-specific care during the first year after transfer, with a trend to leave diabetes-specific care during the observation period. Patients in diabetes-specific care displayed lower HbA1c levels (%/mmol/mol) (7.1/54 vs. 7.5/58). An important predictor for HbA1c after transfer was HbA1c during the year before transfer (r=0.67, p <0.001). Patients living alone showed no difference in HbA1c levels from those living with their parents. Married patients had lower HbA1c levels (7.0/53 vs. 7.3/56, p<0.05) than unmarried ones. Patients with children (15.8%) presented lower HbA1c levels (6.9/52 vs. 7.3/56, p <0.01) than those without.

CONCLUSIONS:

Good metabolic results are favored in patients followed-up in specialized care, are married, and are parents. We recommend transfer to a diabetologist with experience in T1D at an individual age.

• Authors: Roland Schweizer, Martina Lösch-Binder, Clara Hayn, Silas Friz, Julia Uber, Julian Ziegler, Franziska Liebrich, Andreas Neu
• Journal: Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association (Exp Clin Endocrinol Diabetes) Vol. 131 Issue 10 Pg. 532-538 (Oct 2023) ISSN: 1439-3646 [Electronic] Germany
• PMID: 37467782 (Publication Type: Journal Article)
• Copyright: Thieme. All rights reserved.

Chemical References

• Glycated Hemoglobin

Topics

• Humans
• Child
• Adult
• Diabetes Mellitus, Type 1 (therapy, complications)
• Glycated Hemoglobin
• Transition to Adult Care
• Cross-Sectional Studies
• Diabetes Complications