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Multicenter Study
. 2013 Apr;131(4):e1062-70.
doi: 10.1542/peds.2012-1450. Epub 2013 Mar 25.

Transition from pediatric to adult care for youth diagnosed with type 1 diabetes in adolescence

Debra S Lotstein  1 , Michael Seid, Georgeanna Klingensmith, Doug Case, Jean M Lawrence, Catherine Pihoker, Dana Dabelea, Elizabeth J Mayer-Davis, Lisa K Gilliam, Sarah Corathers, Giuseppina Imperatore, Lawrence Dolan, Andrea Anderson, Ronny A Bell, Beth Waitzfelder; SEARCH for Diabetes in Youth Study Group
Collaborators, Affiliations
Multicenter Study

Transition from pediatric to adult care for youth diagnosed with type 1 diabetes in adolescence

Debra S Lotstein et al. Pediatrics. 2013 Apr.

Abstract

Objective: Youth with type 1 diabetes mellitus are at risk for poor glycemic control as they age into adulthood. The aim of this study was to describe sociodemographic and clinical correlates of poor glycemic control associated with the transfer of care from pediatric to adult diabetes providers among a cohort of youth with type 1 diabetes diagnosed in adolescence.

Methods: Analyses included 185 adolescent participants with recently diagnosed type 1 diabetes in the SEARCH for Diabetes in Youth Study with pediatric care at baseline who were age ≥18 years at follow-up. Demographic and clinical factors were measured by survey and laboratory results. Survival analysis was used to estimate the age of transition. Logistic regression analysis assessed the association of demographic and clinical factors with the transition of care and poor glycemic control at follow-up.

Results: Fifty-seven percent of participants had transitioned to adult diabetes care providers by the follow-up visit. The estimated median age of transition of care was 20.1 years (95% confidence interval 19.8-20.4). Older age, lower baseline glycosylated hemoglobin, and less parental education were independently associated with increased odds of transition. The odds of poor glycemic control at follow-up were 2.5 times higher for participants who transitioned to adult care compared with those who remained in pediatric care.

Conclusions: Transferring from pediatric to adult care, experienced by more than half the sample, was associated with an increased risk of poor glycemic control at follow-up. These findings suggest that young adults need additional support when moving to adult care.

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Figures

FIGURE 1
FIGURE 1
Inclusion criteria for transition of care analysis. DM, diabetes mellitus.
See this image and copyright information in PMC

References

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