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Transfer from paediatric to adult care for young adults with Type 2 diabetes: the SEARCH for Diabetes in Youth Study.
Agarwal, S; Raymond, J K; Isom, S; Lawrence, J M; Klingensmith, G; Pihoker, C; Corathers, S; Saydah, S; D'Agostino, R B; Dabelea, D.
Afiliación
  • Agarwal S; Division of Endocrinology, Diabetes, and Metabolism, University of Pennsylvania, USA.
  • Raymond JK; Perelman School of Medicine, Philadelphia, USA.
  • Isom S; Pediatric Endocrinology, Children's Hospital of Los Angeles, Los Angelos, USA.
  • Lawrence JM; Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, USA.
  • Klingensmith G; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, USA.
  • Pihoker C; Barbara Davis Center for Diabetes, University of Colorado, Children's Hospital Colorado, Denver, CO, USA.
  • Corathers S; Department of Pediatrics, University of Washington, Seattle, USA.
  • Saydah S; Division of Endocrinology, Department of Internal Medicine, University of Cincinnati Medical Center, USA.
  • D'Agostino RB; Division of Endocrinology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
  • Dabelea D; Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, USA.
Diabet Med ; 35(4): 504-512, 2018 04.
Article en En | MEDLINE | ID: mdl-29377258
AIM: To describe factors associated with transfer from paediatric to adult care and poor glycaemic control among young adults with Type 2 diabetes, using the SEARCH for Diabetes in Youth study. METHODS: Young adults with Type 2 diabetes were included if they had a baseline SEARCH visit while in paediatric care at < 18 years and ≥ 1 follow-up SEARCH visit thereafter at 18-25 years. At each visit, HbA1c , BMI, self-reported demographic and healthcare provider data were collected. Associations of demographic factors with transfer of care and poor glycaemic control (HbA1c ≥ 75 mmol/mol; 9.0%) were explored with multivariable logistic regression. RESULTS: 182 young adults with Type 2 diabetes (36% male, 75% minority, 87% with obesity) were included. Most (n = 102, 56%) reported transfer to adult care at follow-up; a substantial proportion (n = 28, 15%) reported no care and 29% did not transfer. Duration of diabetes [odds ratio (OR) 1.4, 95% confidence interval (95% CI) 1.1, 1.8] and age at diagnosis (OR 1.8, 95% CI 1.4, 2.4) predicted leaving paediatric care. Transfer to adult or no care was associated with a higher likelihood of poor glycaemic control at follow-up (adult: OR 4.5, 95% CI 1.8, 11.2; none: OR 4.6, 95% CI 1.4, 14.6), independent of sex, age, race/ethnicity or baseline HbA1c level. CONCLUSIONS: Young adults with Type 2 diabetes exhibit worsening glycaemic control and loss to follow-up during the transfer from paediatric to adult care. Our study highlights the need for development of tailored clinical programmes and healthcare system policies to support the growing population of young adults with youth-onset Type 2 diabetes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus Tipo 2 / Transición a la Atención de Adultos Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: Diabet Med Asunto de la revista: ENDOCRINOLOGIA Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus Tipo 2 / Transición a la Atención de Adultos Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: Diabet Med Asunto de la revista: ENDOCRINOLOGIA Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido