Poor Glycemic Control with Pediatric to Adult Diabetes Care Switch
(HealthDay News) – For youth with type 1 diabetes, the transition from pediatric to adult diabetes care is associated with increased risk of poor glycemic control, according to a study published online March 25 in Pediatrics.
Debra S. Lotstein, MD, MPH, from the David Geffen School of Medicine at the University of California Los Angeles, and colleagues described the sociodemographic and clinical correlates of poor glycemic control associated with transfer of care from pediatric to adult diabetes providers. Participants included 185 adolescents with recently diagnosed type 1 diabetes who were in pediatric care at baseline and were age ≥18 years at follow-up.
By the follow-up visit, 57% of participants had moved to adult care providers. The researchers found that transition of care occurred at an estimated median age of 20.1 years. Increased odds of transition were independently associated with older age, lower baseline glycosylated hemoglobin, and less parental education. Compared with participants who remained in pediatric care, those who transitioned to adult care had 2.5-fold increased odds of poor glycemic control at follow-up.
"These findings suggest that to safely follow current guidelines, young adults who transition to adult care require additional support to maximize their health outcomes that will extend for some time beyond the transfer to an adult provider," the authors write.