Evaluation of the transition from paediatric to adult diabetic unit for adolescents with type 1 diabetes

IntroductionThe transition between paediatric and adult care for young people with type 1 diabetes (T1D) is often poorly managed, with adverse consequences for health, as well as a decrease in the follow-up.ObjectiveTo analyse the metabolic control and the degree of satisfaction in a group of patients with T1D after being transferred from the paediatric diabetes unit (PDU) to adult diabetes unit (ADU).Patients and methodsRetrospective study in a cohort of 49 patients (43% female) with T1D. The age at diagnosis and transfer to ADU, time of onset of the disease, metabolic control (HbA1c), presence of diabetic complications and characteristics of medical follow-up were analysed using the statistics program: SPSS, version 17.0.ResultsMean age at diagnosis 8.3 ± 4.6 years and transfer to ADU 19.2 ± 1.8 years. Mean time since onset of T1D in paediatrics, adults and overall: 10.8 ± 5.0, 4.1 ± 2.6 and 15.0 ± 5.7 years, respectively. The 6% of adult patients were not being medically tracked. Among adults, 25% did not provide data about chronic complications, and 6% did not know their last HbA1c. The metabolic control after their transfer to the ADU worsened in 52% of the patients (HbA1c +0.79 ± 0.70%). No correlation was found between the time since onset and the HbA1c value. Degree of satisfaction was either good or very good in 96% of patients in the PDU and 74% in ADU.ConclusionBetter planning for the transfer of paediatric patients with T1D to ADU is highly recommended, in order to avoid deterioration of control and/or loss of follow-up.

ResumenObjetivoAnalizar el control metabólico y grado de satisfacción en un grupo de pacientes con DM1 tras cambiar de Unidad (Pediátrica [UDP], Adultos [UDA]).Pacientes y métodosEstudio retrospectivo: 49 pacientes, 43% mujeres. Analizamos: edad al diagnóstico y paso a adultos, tiempo evolución, control metabólico (HbA1c), complicaciones diabéticas y características del seguimiento. Estudio estadístico: programa SPSS-versión-17.0.ResultadosEdad media ± desviación estándar al diagnóstico 8,3 ± 4,6 y en transferencia 19,2 ± 1,8 años. Tiempo seguimiento en UDP, UDA y global: 10,8 ± 5,0, 4,1 ± 2,6 y 15,0 ± 5,7 años; el 6% perdió el seguimiento médico. En UDA: el 6% desconocía última HbA1c y el 29% las complicaciones crónicas. El control metabólico empeoró en 52% pacientes (aumento HbA1c +0,79 ± 0,70%). No encontramos correlación entre el tiempo evolución y la HbA1c. El 96% de los pacientes refirieron grado satisfacción bueno/muy bueno respecto a UDP y el 74% respecto a UDA.ConclusiónParece necesaria una mejor planificación de la transición de pacientes con DM1 a las UDA para evitar el empeoramiento del control clínico y/o la pérdida de seguimiento.