Health outcomes for youth with type 1 diabetes at 18 months and 30 months post transition from pediatric to adult care

The added value of transition programs in Dutch diabetes care: A controlled evaluation study

“…In a previous study, only 17% of young adults with T1DM (18-25 years) met the ISPAD goal of less than 7.0% (≤ 53 mmol/mol) [35], which is even better than the 10.6% proportion in our study. Although recent registry data of the American Diabetes Association indicate that glycemic control is still not improving, despite advances in technology and newer insulins [36], research suggests that transition interventions may be effective in maintaining glycemic control after transfer to adult care [10,23]. Our study showed a decreasing trend in the number of HbA1c measurements and scheduled consultations after transfer, while poor glycemic control persisted in adult care.…”

“…For instance, HbA1c scores alone do not fully capture diabetes control. Additional information on daily diabetes self-care and signi cant changes in self-care behavior during the transition period would enable to create a more complete picture [10]. Finally, the suboptimal response rate to the questionnaire (38.4%) might be a limitation of this study, although this is comparable with that in other post-transition diabetes studies [40].…”

“…Clinic attendance is crucial to promote self-care and self-management, and consequently diabetes control [10]. Strengthening young adults' con dence in self-management is the third key feature of transitional care associated with improved outcomes, mentioned by Colver et al [31].…”

“…Psychosocial issues are common in this phase, and young T1DM patients have signi cantly higher rates of diabetes-related distress than other age groups [7]. These issues could lead to deterioration of glycosylated hemoglobin (HbA1c) levels with an associated increase in acute and even chronic complications such as ketoacidosis or microvascular problems [8][9][10][11].…”

Recurrent diabetic ketoacidosis and a brief history of brittle diabetes research: contemporary and past evidence in diabetic ketoacidosis research including mortality, mental health and prevention

“…detailed the impact on DKA admission and glycaemic control of a specialist transition diabetes service between paediatric and adult services. They focussed on maintaining a therapeutic relationship during a period of a person's life when circumstances are in a state of flux, including entering higher education, finding work and establishing a family life . Although there were no control groups to establish how participants might have fared without intervention across the two studies, the substantial and sustained fall in single DKA and recurrent DKA episodes after 10‐year follow‐up suggests an impact on behaviour at the time of DKA crisis.…”