Transition to adult care in youth with type 1 diabetes: follow-up continuity, complications, and metabolic control

型糖尿病青少年向成人护理过渡:随访连续性、并发症和代谢控制

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Abstract

INTRODUCTION: The transition from pediatric to adult care in individuals with type 1 diabetes (T1D) often presents significant challenges, including disruptions in follow-up continuity and metabolic control. OBJECTIVE: The aim of this study is to assess healthcare utilization, follow-up continuity, metabolic control (HbA1c levels), and the development of complications after transition to adult care within a transition clinic setting. METHODS: A retrospective analysis was performed on 118 individuals with T1D who transitioned to adult care. Demographic data, along with pre- and post-transition HbA1c levels, chronic complications, treatment modifications, and follow-up attendance, were collected and analyzed. RESULTS: Of the 118 participants, 67% (n = 80) transitioned through the transition council, with 62.5% (n = 50) maintaining regular follow-up in adult care. However, 27.5% (n = 30) experienced follow-up discontinuity. The mean HbA1c in the last year of pediatric care was 7.95 ± 1.27%, which slightly decreased to 7.73 ± 1.17% in the first year of adult care and remained stable at 7.74 ± 1.17% in the second year. Complication rates increased from 18% pre-transition to 26% during adult follow-up. CONCLUSION: Despite the challenges faced during the transition, transition clinics play a crucial role in supporting follow-up continuity and improving metabolic control. Multidisciplinary care and individualized treatment modifications are essential in reducing complication risks. Future research should include larger sample sizes to better address long-term health outcomes and optimize the transition process.

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