Follow-up of adolescents with diabetes after transition from paediatric to adult care: results of a 10-year prospective study.
OBJECTIVE
Our main objective in this study was to identify the type of clinical care received by young type 1 diabetic patients who have made the transition from paediatric to adult care, and to assess the metabolic status of long-term treatment after the transition.


METHODS
A standardized questionnaire was used prospectively to follow 99 patients with type 1 diabetes mellitus after their transition to adult care. This survey was done once a year, from 1998 to 2008.


RESULTS
Directly after transition from paediatric care 38.4% of patients were found at specialised outpatient units; whereas 41.1% received care at a diabetes centre and 20.5% were monitored by general practitioners or specialists in internal medicine. Five-year results showed that 25.0% had continued to visit an outpatient unit; 41.7% were still visiting a diabetes centre; and 33.3% had remained in the care of general practitioners or internal specialists. We observed a trend showing slight improvements in the HbA1c values over time, however no major changes in metabolic control were observed after transition.


CONCLUSIONS
Transition marks a critical phase for young, diabetic patients as they may frequently switch from one physician or centre to another. The individual optimization of therapy, established during paediatric care, provides the decisive groundwork for disease control in young adults.
University Children's Hospital, Tübingen, Germany. andreas.neu@med.uni-tuebingen.de
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Lösch-Binder
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Ehehalt
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Schweizer
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D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D005194:Family Practice / Q000592:standards; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007388:Internal Medicine / Q000592:standards; D008511:Medicine; D010045:Outpatients; D011446:Prospective Studies; D016896:Treatment Outcome
D006442:Glycated Hemoglobin