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Soliman D. Transition from Pediatric to Adult Care in Type 1 Diabetes Mellitus: A Longitudinal Analysis of Clinical Features and Outcomes. Presented at: American Association of Clinical Endocrinology Annual Scientific and Clinical Conference; 26.-29. May 2021 (virtual meeting).
Disclosure:
Soliman does not report any relevant financial information.
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The transition from pediatric to adult diabetes care has been linked to a prolonged gap in care for teenagers and young adults who do not see a diabetes advisor or use a continuous glucose monitor, according to a spokesman.
“Adolescents and young adults with type 1 diabetes who transition from pediatric to adult care have poor blood sugar control and poor health outcomes.” Diana Soliman, MDHealio, a second year endocrinology fellow at Duke University, told Healio. “In this study, we looked at the factors associated with the supply gap.”
Soliman is a second year endocrinology fellow at Duke University.
Researchers conducted a retrospective longitudinal study of 214 adolescents and young adults with type 1 diabetes (54.8% female; 73.4% white) who received at least two within 3 years of their previous pediatric visit to Duke University Health Pediatric endocrinology visits and an adult endocrinology visit were systematic. Data on comorbidities, health care utilization, CGM, and insulin pump use were obtained through electronic health records. The results were presented at the annual AACE Scientific and Clinical Conference.
The study cohort had a mean HbA1c value of 9.4% and it took an average of 7.9 months to transition from pediatric to adult care. After adjusting for socio-demographic and clinical factors, participants had a longer gap in care if not seen by a diabetes counselor (relative effect = 1.68; 95% CI, 1.06-2.67; P = 0.03) or CGM used (relative effect) = 1.86; 95% CI, 1.24-2.79; P <0.01) before transitioning to adult care. HbA1c, insulin pump use, comorbidities, ED visits, and hospital stays were not associated with a supply gap.
Soliman noted that the study’s results were limited as they only included people transitioning to adult care on the Duke University Health System. There were 1,615 people who had at least two pediatric endocrine visits to the Duke University health system, but only 214 who also had an adult visit within the health system were included in the study. Because the study was retrospective, it is unknown how many of the 1,401 people excluded from analysis visited an adult endocrinologist outside of Duke.
“More research is needed to understand which patients are being lost to follow-up,” Soliman said. “We need to understand the impact a longer gap in care has on clinical outcomes and design interventions to improve outcomes for this vulnerable patient population.”
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