Diabetes educators, CGM shorten gap between pediatric and adult care in type 1 diabetes

Source/Disclosures Published by:

Source:

Soliman D. Transition from pediatric to adult care in type 1 diabetes mellitus: a longitudinal analysis of clinical features and outcomes. Presented at: American Association of Clinical Endocrinology Annual Scientific and Clinical Conference; May 26-29, 2021 (virtual meeting).

disclosures:
Soliman does not report any relevant financial disclosures.

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The transition from pediatric to adult diabetes care is associated with a long-term care gap for teens and young adults who do not see a diabetes educator or use a continuous glucose monitor.

“Adolescents and young adults with type 1 diabetes transitioning from pediatric care to adult care have poor glycemic control and health outcomes,” Diana Soliman, MD, a sophomore endocrinology fellow at Duke University, at Healio. “In this study, we looked at which factors are associated with the gap in health care.”

Soliman is a sophomore endocrinology fellow at Duke University.

Researchers conducted a retrospective longitudinal study of 214 adolescents and young adults with type 1 diabetes (54.8% female; 73.4% Caucasian) who had at least two pediatric endocrinology visits and one adult endocrinology visit within 3 years of their previous pediatric visit. at Duke University Health System. Data on comorbidities, health care use, CGM and insulin pump use were obtained from electronic health records. The findings were presented at AACE’s annual scientific and clinical conference.

The study cohort had a mean HbA1c of 9.4% and it took an average of 7.9 months to transition from pediatric care to adult care. After adjusting for socio-demographic and clinical factors, participants had a longer waiting time in care if they had not been seen by a diabetes educator (relative effect = 1.68; 95% CI, 1.06-2.67; P = 0. 03) or CGM (relative effect = 1.86; 95% CI, 1.24-2.79; P < 0.01) before entering adult care. HbA1c, insulin pump use, comorbidities, emergency room visits and hospitalizations were not associated with gap in care.

Soliman noted that the study’s findings were limited because they only included people transitioning to adult care at Duke University Health System. There were 1,615 people who had at least two pediatric endocrine visits to the Duke University Health System, but only 214 who also had an adult visit within the health system were included in the study. Because the study was retrospective, it’s not known how many of the 1,401 people excluded from the analysis visited an adult endocrinologist outside of Duke.

“Further research is needed to understand which patients are lost to follow-up,” Soliman said. “We need to understand the implications of a long-term care gap on clinical outcomes and design interventions to improve outcomes for this vulnerable patient population.”

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Annual Meeting of the American Association of Clinical Endocrinology

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