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Transfer from paediatric to adult care for young adults with Type 2 diabetes: the SEARCH for Diabetes in Youth Study.

Citation
Agarwal, S., et al. “Transfer From Paediatric To Adult Care For Young Adults With Type 2 Diabetes: The Search For Diabetes In Youth Study.”. Diabetic Medicine : A Journal Of The British Diabetic Association, pp. 504-512.
Center University of Washington University of Colorado Denver
Multicenter
Multicenter
Author S Agarwal, J K Raymond, S Isom, J M Lawrence, G Klingensmith, C Pihoker, S Corathers, S Saydah, R B D'Agostino, D Dabelea
Abstract

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, HbA , BMI, self-reported demographic and healthcare provider data were collected. Associations of demographic factors with transfer of care and poor glycaemic control (HbA ≥ 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 HbA 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.

Year of Publication
2018
Journal
Diabetic medicine : a journal of the British Diabetic Association
Volume
35
Issue
4
Number of Pages
504-512
Date Published
12/2018
ISSN Number
1464-5491
DOI
10.1111/dme.13589
Alternate Journal
Diabet. Med.
PMID
29377258
PMCID
PMC6130201
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