The transition to young adulthood in youth with type 1 diabetes on intensive treatment.
OBJECTIVE
We sought to examine prospectively patterns of clinical and psychosocial outcomes during the transition from adolescence to young adulthood in a cohort initiating intensive therapy after the Diabetes Control and Complications Trial.


METHODS
We conducted a prospective, descriptive analysis of data from a randomized intervention study with 117 adolescents (45 males and 72 females, mean age at entry = 14.4 +/- 2.0 yr, mean diabetes duration at entry = 5.7 +/- 3.7 yr) recruited from a large pediatric diabetes clinic. Data were collected for each subject over periods of up to 5 yr at 6-month intervals using measures of depressive symptoms, quality of life, and metabolic control, with chart review for prevalence of diabetes complications.


RESULTS
Metabolic control worsens during adolescence but returns to early adolescent levels in young adulthood. The negative impact of diabetes on quality of life, disease-related worries, and life satisfaction did not change significantly with age. These results did not vary with treatment group or gender. Participants who showed high levels of depressive symptoms as adolescents were somewhat more likely to be depressed when older. Despite relatively long duration of diabetes, relatively few complications were observed in young adulthood.


CONCLUSIONS
These data suggest that youth who begin intensive treatment as adolescents generally have good metabolic and psychosocial outcomes as young adults. However, those who have high levels of depressive symptoms in adolescence tend to continue to have such symptoms in early adulthood.
Yale University School of Nursing, New Haven, CT, USA.
Glendessa
G
Insabella
Margaret
M
Grey
George
G
Knafl
William
W
Tamborlane
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000378:metabolism / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life