[Treatment of young patients with type 1 diabetes in an adult diabetes clinic].
BACKGROUND
It is well known that children and adolescents with type 1 diabetes mellitus (DM) treated in outpatient clinics often have poor metabolic control and thereby a high risk of developing microvascular complications. Our aim was to determine the status of the young type 1 DM patients under 25 years of age attending our adult outpatient diabetes clinic.


METHODS
Retrospectively, we registered HbA1c, screening for complications, success with self-care and non-attendance. We suggest criteria for determining the success of the treatment process and outcome.


RESULTS
Thirty-four patients, age 22.2 +/- 2.7 years, attend the clinic. Their latest HbA1c was 9.2 +/- 1.9% (mean SD); 18% had HbA1c pound 7.5%. Intensive insulin therapy was used by 91%. Five patients had either background retinopathy, elevated urinary albumin to creatinine ratio or hypertension ( 130/80) on one occasion within the last two years. Dietary problems were listed in 29% of the records, and insufficient frequency of blood glucose measurements appeared in 29%, while 38% had between three and seven non-attendances. The patients in all three of these groups had significantly higher HbA1c. Screening for complications was successful according to the criteria for blood pressure, HbA1c and retinopathy, but not completely successful for nephropathy and neuropathy.


CONCLUSIONS
The young type 1 diabetes patients attending our adult outpatient clinic have an unsatisfactorily high HbA1c. Screening for complications is sufficient, and hardly any of the patients have signs of complications, but the rate of non-attendance is high, and there are significant problems with self-care. New individual considerations for these young patients appear to be necessary and standards for the quality of treatment are needed.
Hobolth
Lise
L
H:S Hvidovre Hospital, Endokrinologisk Afdeling, Hvidovre. jul.hobolth@dadlnet.dk
Nørgaard
Kirsten
K
D000293:Adolescent; D000328:Adult; D048909:Diabetes Complications / Q000175:diagnosis / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance; D010352:Patient Dropouts; D010353:Patient Education as Topic / Q000592:standards; D012189:Retrospective Studies; D012648:Self Care / Q000592:standards; D016896:Treatment Outcome; D000078329:Workforce
D006442:Glycated Hemoglobin; D007328:Insulin