Glycemic control and transfer of health care among adolescents with insulin dependent diabetes mellitus.
OBJECTIVE
To describe glycemic control among older adolescents with insulin dependent diabetes mellitus (IDDM) as they move from pediatric to adult-focused health care.


METHODS
Prospective cohort study conducted in a university medical center. Participants included 82 consecutive adolescents (50 males and 32 females) with IDDM transferred from a pediatric to an adolescent/young adult diabetes clinic. Main outcome measures were the levels of total stable glycosylated hemoglobin (HbA1) obtained at each visit for up to one year before and after the transfer.


RESULTS
The average age of transfer to the young adult clinic was 17.3 +/- 0.8 years. Mean age at onset of IDDM was 9.6 +/- 4.2 years (1.2 to 17.3) with duration of 7.7 +/- 3.9 years (0.7 to 16.1). Glycemic control remained unchanged following transfer (9.9% +/- 1.8 vs 10.2% +/- 1.9; t = 1.6; p = 0.125). Following transfer, both males and females maintained similar levels of glycemic control (9.8% +/- 1.7 and 10.7% +/- 1.8 respectively); although the difference between males and females was significant (t = -2.0; p = 0.048) following transfer, there was no difference in the degree of change by gender (t = -2.0; p = 0.8). In both pediatric and young adult clinics, there was no relationship between duration of IDDM (< 5 vs > or = 5 years) and HbA1.


CONCLUSIONS
Transfer to an adult-focused diabetes program appears to have no negative impact on glycemic control.
Orr
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DP
Section of Adolescent Medicine, Indiana University Medical Center, Indianapolis, 46202, USA.
Fineberg
N S
NS
Gray
D L
DL
D000293:Adolescent; D016497:Adolescent Health Services; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006785:Hospitals, University; D006801:Humans; D007196:Indiana; D008297:Male; D010348:Patient Care Team; D010360:Patient Transfer / Q000706:statistics & numerical data; D011446:Prospective Studies; D012737:Sex Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin