Transition From Childhood to Adult Care in Patients with Type 1 Diabetes: 20 Years of Experience From the Tübinger Transition Study.

IF 1.6 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Experimental and Clinical Endocrinology & Diabetes Pub Date : 2023-10-01 Epub Date: 2023-07-19 DOI:10.1055/a-2132-9585
Roland Schweizer, Martina Loesch-Binder, Clara Hayn, Silas Friz, Julia Uber, Julian Ziegler, Franziska Liebrich, Andreas Neu
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Abstract

Aims: Transition from pediatric to adult care is difficult for patients with chronic diseases. In this study, factors associated with metabolic control in childhood-onset type 1 diabetes (T1D) after transfer to adult care were analyzed.

Methods: Overall, 224 persons with T1D were contacted yearly from 1998 to 2019. They voluntarily answered a questionnaire about their current hemoglobin A1c (HbA1c) levels, diabetes-associated complications, kind of care, living conditions, and family situation. Then, mixed longitudinal-cross-sectional analyses were carried out.

Results: Overall, 190 patients answered at least once (mean age: 26.6 years). Diabetes complications were mentioned by 10 patients (5 microalbuminuria, 5 retinopathy). Most patients (92.6%) were in diabetes-specific care during the first year after transfer, with a trend to leave diabetes-specific care during the observation period. Patients in diabetes-specific care displayed lower HbA1c levels (%/mmol/mol) (7.1/54 vs. 7.5/58). An important predictor for HbA1c after transfer was HbA1c during the year before transfer (r=0.67, p <0.001). Patients living alone showed no difference in HbA1c levels from those living with their parents. Married patients had lower HbA1c levels (7.0/53 vs. 7.3/56, p<0.05) than unmarried ones. Patients with children (15.8%) presented lower HbA1c levels (6.9/52 vs. 7.3/56, p <0.01) than those without.

Conclusions: Good metabolic results are favored in patients followed-up in specialized care, are married, and are parents. We recommend transfer to a diabetologist with experience in T1D at an individual age.

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1型糖尿病患者从儿童护理向成人护理的过渡:Tübinger过渡研究的20年经验。
目的:慢性病患者很难从儿科护理过渡到成人护理。在这项研究中,分析了儿童期1型糖尿病(T1D)转移到成人护理后与代谢控制相关的因素。方法:从1998年到2019年,每年接触224名T1D患者。他们自愿回答了一份关于他们目前血红蛋白A1c(HbA1c)水平、糖尿病相关并发症、护理方式、生活条件和家庭状况的问卷。然后,进行了混合纵向截面分析。结果:总的来说,190名患者至少回答了一次(平均年龄:26.6岁)。10名患者提到糖尿病并发症(5例微量白蛋白尿,5例视网膜病变)。大多数患者(92.6%)在转移后的第一年接受了糖尿病特定护理,在观察期内有离开糖尿病特定护理的趋势。接受糖尿病特殊护理的患者HbA1c水平较低(%/mmol/mol)(7.1/54 vs.7.5/58)。转移后HbA1c的一个重要预测因素是转移前一年的HbA1c(r=0.67,p vs.7.3/56,pvs.7.3/56。p结论:在专业护理中随访、已婚和为人父母的患者有利于获得良好的代谢结果。我们建议在个别年龄转到有T1D经验的糖尿病学家那里。
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来源期刊
CiteScore
4.10
自引率
5.60%
发文量
72
审稿时长
3 months
期刊介绍: Publishing outstanding articles from all fields of endocrinology and diabetology, from molecular biology to clinical research, this journal is a brilliant resource. Since being published in English in 1983, the popularity of this journal has grown steadily, reflecting the importance of this publication within its field. Original contributions and short communications appear in each issue along with reviews addressing current topics. In addition, supplementary issues are published each year presenting abstracts or proceedings of national and international scientific meetings. The journal was initially published in German and is still the oldest endocrinological periodical in the German-language market!
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