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. 2024 Aug;61(8):1069-1076.
doi: 10.1007/s00592-024-02268-3. Epub 2024 May 3.

From pediatric to adult care: a survey on the transition process in type 1 diabetes mellitus and the diabetes services in Italy

Vanna Graziani  1 , Tosca Suprani  2 , Paolo Di Bartolo  3 , Federico Marchetti  2 ; TransiDEA study group
Collaborators, Affiliations

From pediatric to adult care: a survey on the transition process in type 1 diabetes mellitus and the diabetes services in Italy

Vanna Graziani et al. Acta Diabetol. 2024 Aug.

Abstract

Aims: The present study assessed the transitioning process of young adults with type 1 diabetes mellitus (T1D) in Italy.

Materials and methods: We asked Pediatric Diabetes Centers (PDC) and Adult Diabetes Centers (CAD) to fill in a web-based survey on the current state of services, the number of transitioning adolescents with T1D within the last year, observations on limitations, and future directions.

Results: 93 centers (46 PDCs, 47 CADs) joined the study. The total number of subjects with T1D being followed by a PDC was 16,261 (13,779 minors and 2483 young adults), while CADs had 25,500 patients. The survey showed an uneven situation. Only some services had a dedicated diabetes team (78% of PDCs, 64% of CADs). 72% of PDCs and 58% of CADs reported a protocol dedicated to transition. The median age for transition was 19 (range 16-25 years); the time required for preparing transition, indicated by both PDCs and CADs, was 5.5 months. A high percentage of CADs (80%) confirmed receiving sufficient clinical information, mainly through paper or computerized reports. The transition process is hampered by a lack of resources, logistical facilities, and communication between services. While some services have a protocol, monitoring of results is only carried out in a few cases. Most specialists expressed the need to enhance integration and continuity of treatment.

Conclusions: The current situation could be improved. Applying standard guidelines, taking into consideration both clinicians' and patients' necessities, would lead to a more successful transition process.

Keywords: Health services; Survey; Transition; Type 1 diabetes.

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