title: Glycemic control and clinic attendance of emerging adults with type 1 diabetes at a transition care clinic.
abstract: BACKGROUND
  Emerging adulthood is a challenging period for diabetes management. Our aim was to determine whether a dedicated transition clinic for emerging adults with type 1 diabetes can improve glycemic control and visit attendance.
  
  
  METHODS
  An observational study of 53 emerging adults (30 males) treated during 2010-2014 in a newly established transition clinic. The clinic was operated jointly by pediatric and adult endocrinologists and included a transition coordinator. Data collected included the source of referral, HbA1c levels, frequency of visit attendance, and acute complications. For 27 patients who had attended the pediatric clinic at the same medical center, data from up to 2 years preceding the transition were also collected. Patients filled the Diabetes Quality of Life-Youth questionnaire at the transition and 1 year later.
  
  
  RESULTS
  Mean ± SD age at the transfer to the transition clinic was 22.1 ± 2.7 years; mean disease duration was 8.4 ± 5.0 years. Follow-up duration at the transition clinic was 1.2 ± 1.1 years. Mean HbA1c levels decreased from 67 mmol/mol (95 % CI 63-72) [8.3 % (95 % CI 7.9-8.7)] at transfer to 57 mmol/mol (95 % CI 52-63) [7.4 % (95 % CI 6.9-7.9)] after 1 year (p < 0.001). Thirty-six patients (68 %) attended three or more visits during their first year in the transition clinic. The impact of diabetes on quality of life, disease-related worries, and life satisfaction did not change significantly during 1-year attendance in the transition clinic.
  
  
  CONCLUSIONS
  A dedicated transition clinic for emerging adults, with tailored support according to the developmental needs of emerging adulthood, showed improved glycemic control and visit attendance.
authors: Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621, Tel Hashomer, Israel. yael.levy.shraga@gmail.com.|Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. yael.levy.shraga@gmail.com.
authors: Y
authors: Y
authors: Levy-Shraga
authors: Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621, Tel Hashomer, Israel.|Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors: N
authors: N
authors: Elisha
authors: Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621, Tel Hashomer, Israel.|Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors: M
authors: M
authors: Ben-Ami
authors: The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel.
authors: V
authors: V
authors: Boyko
authors: Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.|The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel.
authors: L
authors: L
authors: Lerner-Geva
authors: Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel.
authors: T
authors: T
authors: Ziv
authors: Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel.
authors: N
authors: N
authors: Konvalina
authors: Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.|Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel.
authors: O
authors: O
authors: Cohen
authors: Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621, Tel Hashomer, Israel.|Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors: O
authors: O
authors: Pinhas-Hamiel
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D010358:Patient Participation / Q000706:statistics & numerical data*; D011788:Quality of Life; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care / Q000706:statistics & numerical data; D000069341:Transitional Care / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Joint clinic; Transition; Type 1 diabetes mellitus; Young adults