BACKGROUND The period of transition of patients with type 1 diabetes from pediatric to adult-oriented health care is very vulnerable time, as it is associated with poorer glycemic control and less frequent clinic attendance. Fears and anxiety about the unknown, differences in the approach to care in adult settings, and sadness about leaving the pediatric provider all contribute to a patient’s reluctance to transition. OBJECTIVE The purpose of this study was to evaluate psychological parameters of transitioning young patients with type 1 diabetes during the 1st visit in adult outpatient clinic. METHODS We examined 50 consecutive patients (56% females) transitioning from 02.03.2021 - 21.11.2022 into adult care (3 diabetes centers from 3 regions in southern Poland (A=16; B=21; C= 13)) and their basic demographic information. All patients fulfilled the following psychological questionnaires: State-Trait Anxiety Inventory (STAI), Generalized Self-Efficacy Scale (GSES), Perceived Stress Scale (PSS-10), Satisfaction with Life Scale (SWLS), Acceptance of Illness Scale (AIS), Multidimensional Health Locus of Control Scale Form C (MHLC) and Courtauld Emotional Control Scale (CECS). Furthermore, we made comparison of data obtained in the study with data for general healthy population and general population with persons with diabetes available from Polish Test Laboratory during validation studies. RESULTS During the first adult outpatients visit patients mean age was 19.2±1.4 yrs. with 9.8±4.3 yrs. of diabetes duration and BMI 23.5±3.1 kg/m2. Participants came from diverse socioeconomic backgrounds: 36% live in village, 26% live in town up to 100,000 inhabitants and 38% live in bigger cities. Considering the therapy type: 67% of patients were treated with insulin pump therapy while 33% with multiple daily injections. Patients from center A had mean HbA1c 7.5±1.2. There was no difference regarding the level of life satisfaction, perceived level of stress and state anxiety between studied population and general/diabetes population. Studied patients had similar locus of health control and negative emotions control in comparison to general population of diabetes. Patients had higher level of suppression of negative emotions: anger, depression, and anxiety than age matched general population. In addition, our population was characterized by higher acceptance of illness and higher level of self-efficacy compared to general/diabetes population. According to the results 64% of our patients had high level of self-efficacy and 26% high level of life satisfaction. CONCLUSIONS This study indicated that good psychological resources and coping mechanisms of young patients transitioning to adult outpatient clinic might result in adequate adaptation and adult life satisfaction including future metabolic control. Those result also prove wrong the stereotypes that young person with chronic disease has worse life perspective entering adulthood.

Background The transition period of patients with type 1 diabetes from pediatric to adult-oriented health care is associated with poorer glycemic control and less frequent clinic attendance. Fears and anxiety about the unknown, care approach differences in adult settings, and sadness about leaving the pediatric provider all contribute to a patient’s reluctance to transition. Objective This study aimed to evaluate the psychological parameters of young patients with type 1 diabetes transitioning to an adult outpatient clinic during the first visit. Methods We examined 50 consecutive patients (n=28, 56% female) transitioning from March 2, 2021, to November 21, 2022, into adult care (3 diabetes centers from 3 regions in southern Poland: A, n=16; B, n=21; and C, n=13) and their basic demographic information. They completed the following psychological questionnaires: State-Trait Anxiety Inventory (STAI), Generalized Self-Efficacy Scale, Perceived Stress Scale, Satisfaction with Life Scale, Acceptance of Illness Scale, Multidimensional Health Locus of Control Scale Form C, Courtauld Emotional Control Scale, and Quality of Life Questionnaire Diabetes. We compared their data with those for the general healthy population and patients with diabetes from Polish Test Laboratory validation studies. Results During the first adult outpatient visit, patients’ mean age was 19.2 (SD 1.4) years, with a diabetes duration of 9.8 (SD 4.3) years and BMI of 23.5 (SD 3.1) kg/m2. Patients came from diverse socioeconomic backgrounds: 36% (n=18) live in villages, 26% (n=13) live in towns with ≤100,000 inhabitants, and 38% (n=19) live in bigger cities. Regarding therapy type, 68% (n=34) were treated with insulin pump therapy, whereas 32% (n=16) were treated with multiple daily injections. Patients from center A had a mean glycated hemoglobin level of 7.5% (SD 1.2%). There was no difference regarding the level of life satisfaction, perceived level of stress, and state anxiety between the patients and reference populations. Patients had similar health locus of control and negative emotions control to the general population of patients with diabetes. Most patients (n=31, 62%) believe that control over their health depends on themselves, whereas 52% (n=26) believe that it depends mostly on others. Patients had higher levels of suppression of negative emotions—anger, depression, and anxiety—than the age-matched general population. Additionally, the patients were characterized by a higher acceptance of illness and higher level of self-efficacy compared to the reference populations: 64% (n=32) had a high level of self-efficacy and 26% (n=13) had a high level of life satisfaction. Conclusions This study indicated that young patients transitioning to adult outpatient clinics have good psychological resources and coping mechanisms, which might result in adequate adaptation and adult life satisfaction including future metabolic control. These result also disprove the stereotypes that young people with chronic disease have worse life perspectives when entering adulthood.