Growing up with type 1 diabetes mellitus: Data from the Verona Diabetes Transition Project

Abstract

Aim: Transition from paediatric to adult care is a critical step in life of emerging adults with type 1 diabetes. We assessed, according to indicators established by panel of experts, clinical, socio-demographic and psychosocial factors in young adults with type 1 diabetes throughout structured transition to investigate the associations, if any, with HbA 1c value at time of transition. Methods:The "Verona Diabetes Transition Project" started in January 2009: a structured transition program, shared between paediatric and adult clinic, was organised with a multi-disciplinary team. All young adults underwent a semistructured interview by a psychologist, before transition. Minimum age for transition was 18 years.Results: 222 (M/F = 113/109) young adults moved to adult care from January 2009 to March 2020. The mean time between the last paediatric visit and the first adult visit ranged from 13.6 ± 6.1 months at the beginning of the project to 3.6 ± 11.5 months over the following years. At first adult clinic attendance, women showed higher HbA 1c values (70 ± 11 mmol/mol vs. 65 ± 7 mmol/mol or 8.57% ± 1.51% vs. 8.14% ± 0.98%, p = 0.01), higher frequency of disorders of eating behaviours (15.6% vs. 0%, p < 0.001) and poor diabetes acceptance (23.9% vs. 9.7%, p < 0.001) than men. Mediation analyses showed a significant mediating role of glucose control 2 years before transition in the relationship between poor diabetes acceptance and glucose control at transition. Conclusions:This study demonstrated a delay reduction in establishing care with an adult provider and suggested the potential role of low diabetes acceptance on glycemic control at transition. Further studies are needed to confirm and expand these data. K E Y W O R D Sacceptance of disease and psychological issues, emerging adults, glucose control, transition, type 1 diabetes mellitus

Lack of consideration of socioeconomic factors in transition programme of adolescents with type 1 diabetes: A systematic review

“…Pasquini reported a correlation between educational level and HbA1c at transition. However, such information remains difficult to interpret because the average age of transition for the 222 young adults is 24.4 ± 5.8 years, meaning that some may have pursued higher education while others may have been too young 35 …”

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

“…With a response rate of almost 85% (190/224 patients sent back at least one questionnaire), our results give a good overview of evolution of people with T1D after transfer to adult health service in Germany. 10 This article is protected by copyright. All rights reserved.…”

“…The observation period covered 20 years. In contrast to previous studies that analyzed the outcome of structured transition programs in shorter periods of up to 3 years [7][8][9][10][11], we described the impact of an everyday transition process implemented by a pediatric diabetes center. With a response rate of almost 85 % (190/224 patients returning at least one questionnaire), our results offer a good overview of the evolution of people with T1D after the transfer to adult health services in Germany.…”

Lifetime risk and health-care burden of diabetic ketoacidosis: A population-based study

“…patients omitting inulin to induce weight loss), cognitive problems (e.g. attention deficit), binge alcohol consumption, and hazardous and risk-taking behavior inherent to adolescence ( 1 , 25 – 27 ). In addition, increased autonomy in the management of diabetes with refusal of further parental support and the strong need to be accepted outside the family, especially by the peer group, result in less stringent diabetes treatment.…”