10.5061/DRYAD.TDZ08KPZH
Leung, Joseph
0000-0002-3124-3692
University of British Columbia
Type 1 diabetes adolescent transition study
Dryad
dataset
2020
2021-01-04T00:00:00Z
2021-01-04T00:00:00Z
en
129204 bytes
3
CC0 1.0 Universal (CC0 1.0) Public Domain Dedication
Objectives: Adolescents with type 1 diabetes experience dramatic
excursions in blood sugars as they transition to adult care. Trials on
single interventions have struggled to demonstrate lasting improvements in
clinical outcomes. Thus, the purpose of this study was to evaluate the
effect of a multi-component intervention on glycemic control, clinic
attendance, and diabetes distress amongst adolescents with type 1 diabetes
transitioning to adult health services. Design: Prospective controlled
quasi-experimental study. Setting: Adolescents with type 1 diabetes from
an urban academic pediatric hospital (control group) and a community
regional hospital (intervention group) were recruited and followed for 1
year after their last pediatric diabetes visit. Participants: 101
adolescents with type 1 diabetes transitioning to adult care, including 68
from the control group and 33 from the intervention group. Interventions:
The intervention group had access to (1) a diabetes nurse transition
coordinator, (2) joint pediatric-adult diabetes clinic visits, and (3)
pediatric and adult clinics being in the same building. Those in the
control group were referred to an adult diabetes provider at their last
pediatric diabetes visit without any formal transition program or
additional supports. Primary and secondary outcome measures: The primary
outcome was longitudinal change in A1C. The secondary outcomes were number
of A1C tests obtained, number of adult diabetes visits attended, time gap
between pediatric and adult visits, and diabetes distress. Results: There
was a difference in A1C trajectory between the control and intervention
groups (base model p=0.004, adjusted model p=0.003). A1C continued to rise
in the control group after the transition to adult care, whereas A1C
decreased in the intervention group. However, there were no statistically
significant differences in the secondary outcomes between the two groups.
Conclusion: A multi-component intervention can mitigate the glycemic
excursions experienced by adolescents with type 1 diabetes transitioning
to adult care.