Katharine C Garvey1, Nicole C Foster2, Shivani Agarwal3, Linda A DiMeglio4, Barbara J Anderson5, Sarah D Corathers6, Marisa E Desimone7, Ingrid M Libman8, Sarah K Lyons5, Anne L Peters9, Jennifer K Raymond10, Lori M Laffel11. 1. Boston Children's Hospital, Boston, MA. 2. Jaeb Center for Health Research, Tampa, FL t1dstats@jaeb.org. 3. University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 4. Indiana University School of Medicine, Indianapolis, IN. 5. Baylor College of Medicine, Houston, TX. 6. Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH. 7. State University of New York Upstate Medical University, Syracuse, NY. 8. Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA. 9. Keck School of Medicine of the University of Southern California, Los Angeles, CA. 10. Barbara Davis Center for Diabetes, Aurora, CO. 11. Joslin Diabetes Center, Boston, MA.
Abstract
OBJECTIVE: Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. We developed a survey to evaluate transition experiences in two groups of young adults with type 1 diabetes, before (PEDS) and after (ADULT) transition to adult care. RESEARCH DESIGN AND METHODS: We fielded an electronic survey to young adults (18 to <30 years) at 60 T1D Exchange Clinic Registry centers. RESULTS: Surveys were completed by 602 young adults, 303 in the PEDS group (60% female, age 20 ± 2 years) and 299 in the ADULT group (62% female, age 24 ± 3 years). In the PEDS group, mean anticipated transition age was 22 ± 2 years; 64% remained in pediatric care because of emotional attachment to the provider. The ADULT group transitioned at age 19 ± 2 years, mainly after pediatric provider recommendation. More than 80% of respondents reported receiving counseling on type 1 diabetes self-management and screening tests from pediatric providers, but less than half (43% PEDS and 33% ADULT) reported discussing reproductive health. In the PEDS group, half had discussed transfer with pediatric providers. Of the ADULT participants, 63% received an adult provider referral, and 66% felt mostly/completely prepared to transition. ADULT participants with fewer pretransition pediatric visits or who felt unprepared for transition had increased odds of gaps >6 months between pediatric and adult care. Receipt of transition preparation counseling was not associated with self-reported hemoglobin A1c <7.0% in either group. CONCLUSIONS: These results support the need for intensive efforts to integrate transition preparation counseling and care coordination into pediatric type 1 diabetes care.
OBJECTIVE: Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. We developed a survey to evaluate transition experiences in two groups of young adults with type 1 diabetes, before (PEDS) and after (ADULT) transition to adult care. RESEARCH DESIGN AND METHODS: We fielded an electronic survey to young adults (18 to <30 years) at 60 T1D Exchange Clinic Registry centers. RESULTS: Surveys were completed by 602 young adults, 303 in the PEDS group (60% female, age 20 ± 2 years) and 299 in the ADULT group (62% female, age 24 ± 3 years). In the PEDS group, mean anticipated transition age was 22 ± 2 years; 64% remained in pediatric care because of emotional attachment to the provider. The ADULT group transitioned at age 19 ± 2 years, mainly after pediatric provider recommendation. More than 80% of respondents reported receiving counseling on type 1 diabetes self-management and screening tests from pediatric providers, but less than half (43% PEDS and 33% ADULT) reported discussing reproductive health. In the PEDS group, half had discussed transfer with pediatric providers. Of the ADULT participants, 63% received an adult provider referral, and 66% felt mostly/completely prepared to transition. ADULT participants with fewer pretransition pediatric visits or who felt unprepared for transition had increased odds of gaps >6 months between pediatric and adult care. Receipt of transition preparation counseling was not associated with self-reported hemoglobin A1c <7.0% in either group. CONCLUSIONS: These results support the need for intensive efforts to integrate transition preparation counseling and care coordination into pediatric type 1 diabetes care.
Authors: S Kipps; T Bahu; K Ong; F M Ackland; R S Brown; C T Fox; N K Griffin; A H Knight; N P Mann; H A W Neil; H Simpson; J A Edge; D B Dunger Journal: Diabet Med Date: 2002-08 Impact factor: 4.359
Authors: W H Polonsky; B J Anderson; P A Lohrer; G Welch; A M Jacobson; J E Aponte; C E Schwartz Journal: Diabetes Care Date: 1995-06 Impact factor: 19.112
Authors: Joyce P Yi-Frazier; Kirsten Senturia; Davene R Wright; Cara Lind; Faisal S Malik Journal: J Pediatr Nurs Date: 2021-07-20 Impact factor: 2.523
Authors: Yuehtao Chiang; Peikwei Tsay; Chiwen Chen; Chienlung Hsu; Hsingyi Yu; Chiwen Chang; Fusung Lo; Philip Moons Journal: Int J Environ Res Public Health Date: 2021-07-04 Impact factor: 3.390