UBC Research Data

Type 1 diabetes adolescent transition study Leung, Joseph

Description

Abstract

Objectives: Adolescents with type 1 diabetes experience dramatic excursions in blood sugars as they transition to adult care. Trials on single interventions have struggled to demonstrate lasting improvements in clinical outcomes. Thus, the purpose of this study was to evaluate the effect of a multi-component intervention on glycemic control, clinic attendance, and diabetes distress amongst adolescents with type 1 diabetes transitioning to adult health services.

Design: Prospective controlled quasi-experimental study.

Setting: Adolescents with type 1 diabetes from an urban academic pediatric hospital (control group) and a community regional hospital (intervention group) were recruited and followed for 1 year after their last pediatric diabetes visit.

Participants: 101 adolescents with type 1 diabetes transitioning to adult care, including 68 from the control group and 33 from the intervention group.

Interventions: The intervention group had access to (1) a diabetes nurse transition coordinator, (2) joint pediatric-adult diabetes clinic visits, and (3) pediatric and adult clinics being in the same building. Those in the control group were referred to an adult diabetes provider at their last pediatric diabetes visit without any formal transition program or additional supports.

Primary and secondary outcome measures: The primary outcome was longitudinal change in A1C. The secondary outcomes were number of A1C tests obtained, number of adult diabetes visits attended, time gap between pediatric and adult visits, and diabetes distress.

Results: There was a difference in A1C trajectory between the control and intervention groups (base model p=0.004, adjusted model p=0.003). A1C continued to rise in the control group after the transition to adult care, whereas A1C decreased in the intervention group. However, there were no statistically significant differences in the secondary outcomes between the two groups.

Conclusion: A multi-component intervention can mitigate the glycemic excursions experienced by adolescents with type 1 diabetes transitioning to adult care.

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