Difficultés de prise en charge de jeunes diabétiques en transition

This retrospective study was conducted on a group of 51 diabetic adults < 25 years, admitted for the first time in our adult diabetes department at GHPSJ (Groupe Hospitalier Paris Saint-Joseph) between 1st January 2010 and 1st April 2015, without prior consultation, or any preparation, and previously followed in pediatrics units. Data analysis shows: absence of any relay, mean HbA1c > 10%, heterogeneity of prior structures following these patients, many failures in the knowledge on their disease, poor compliance, often inadequate behavior and depression. Similarly, the initial management in our structure has been probably too ambitious, allowing for a self-criticism based on the present study. It is not question of criticizing the previous structures of these “selected” patients. Direct hospitalization without preparation should be considered as a bias of our work. Nevertheless, the medical literature is relatively poor in this field, including few models or tools intended to guide or help these young patients in difficulty, their parents, and caregivers. Similarly, the capacity for autonomy of these patients seems quite overestimated, the age of administrative «majority» being usually different from their true maturity. Prospective studies are desirable to ensure a personalized transition of these patients and to expect progress in this area, as emphasized by this study.