title: Glycemic control over 3 years in a young adult clinic for patients with type 1 diabetes.
abstract: OBJECTIVE
  To evaluate the effect of specialized young adult diabetes clinic (YAC) on glycemic control in a young adult patients with type 1 diabetes (DM1) transitioning from pediatric to adult diabetes care.
  
  
  METHODS
  HbA1c was retrospectively analyzed through 3 years in 15-25 y/o DM1 patients entering a YAC, and compared to similar patients entering general endocrine clinics (GEC) in a university diabetes center.
  
  
  RESULTS
  Ninety-six patients were seen in the YAC, compared to 153 patients in the GEC. No difference in HbA1c was seen at entry (YAC 9.0+/-2.3% versus 8.8+/-2.3%). HbA1c did not change over time in either clinic (mean 3-year HbA1c 8.6+/-2.1% in YAC versus 8.4+/-2.3% in GEC). When the HbA1c values were divided into tertiles, no differences in distribution of baseline HbA1c were seen. Within the highest tertile, the YAC had a greater fall in HbA1c, compared to the GEC. Pump users from both clinics had HbA1c values 1% lower at each time point.
  
  
  CONCLUSIONS
  Young adults with DM1 continue to have difficulty achieving target HbA1c values. Earlier use of pump therapy and a specialized YAC for those with the worst glycemic control will benefit this population.
authors.affiliation: Department of Internal Medicine, University of Nebraska Medical Center, 983020 Nebraska Medical Center, Omaha, NE 68198-3020, USA. jtlane1@unmc.edu
authors.forename: James T
authors.initials: JT
authors.lastname: Lane
authors.forename: Agnes
authors.initials: A
authors.lastname: Ferguson
authors.forename: Joyce
authors.initials: J
authors.lastname: Hall
authors.forename: Maxine
authors.initials: M
authors.lastname: McElligott
authors.forename: Marilyn
authors.initials: M
authors.lastname: Miller
authors.forename: Pascale H
authors.initials: PH
authors.lastname: Lane
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Pfeffer
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000375:Aging / Q000502:physiology; D000419:Albuminuria / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D005260:Female; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male
chemical_list: D001786:Blood Glucose