Becoming an Adult with Type 1 Diabetes

Type 1 diabetes patients who moved on to adult care had worse blood sugar control

(RxWiki News) As there is no cure for type 1 diabetes, many children continue to battle the condition into adulthood. But it remains unclear when these patients typically move from pediatric care providers to adult healthcare providers.

In a recent study, researchers wanted to better understand the process of transferring from pediatric care to adult care in youth with type 1 diabetes and how that process affected the health of those young people.

The study's results showed that type 1 diabetes patients who shifted from pediatric to adult care had 2.5 times higher odds of poor blood sugar control than those who stayed in pediatric care.

According to the researchers, these findings suggest that young adults with type 1 diabetes may need more support when transitioning into adult care.

"Work with an endocrinologist to control your diabetes."

The research was led by Debra S. Lotstein, MD, MPH, of the David Geffen School of Medicine at the University of California Los Angeles.

According to Dr. Lotstein and colleagues, "Youth with type 1 diabetes mellitus are at risk for poor [blood sugar] control as they age into adulthood."

Therefore, the researchers set out to describe certain aspects of poor blood sugar control that may be associated with the transition of care from pediatric to adult diabetes care providers among a group of young people with type 1 diabetes.

"The transition to adulthood can include changes in healthcare providers, insurance and often living situations as patients move from high school to college or work," Dr. Lotstein told the UCLA Newsroom.

"These transitions can be challenging for anyone, but youth with a chronic health problem like diabetes are at risk of losing the support of their healthcare providers and their family that helps them stay healthy," she continued. "When this transition goes poorly, it increases the risk of worse health outcomes in adulthood."

For patients with type 1 diabetes, these worse health outcomes could mean heart attack, stroke, blindness and kidney failure.

The current study included 185 teenage participants with recently diagnosed type 1 diabetes in the SEARCH for Diabetes in Youth Study. At the beginning of the study, these patients were receiving pediatric care. By the time of follow-up, all participants were 18 years of age or older.

At follow-up, 57 percent of participants had shifted into adult diabetes care. The median age at which patients made this shift was about 20.1 years of age.

Participants were more likely to shift into adult care if they were older, had lower blood sugar levels at the beginning of the study or had parents with lower levels of education.

"One surprise was that those patients with poor diabetes control were more likely to stay with their pediatric providers, compared to others," Dr. Lotstein said. "We theorized that the doctors have a higher level of concern for those patients with poor control and may care for them longer in an attempt to prevent their condition from worsening."

According to the authors, the next step in this research is to follow young type 1 diabetes patients through the transition to adult care in order to see what happens as they grow older and to assess how different support strategies can impact health outcomes.

The study was published March 25 in the journal Pediatrics

The Centers for Disease Control and Prevention (CDC) and the National Institute of Diabetes and Digestive and Kidney Diseases provide funding to the SEARCH for Diabetes in Youth Study. 

The authors disclosed no financial ties.

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Review Date: 
March 25, 2013
Last Updated:
August 16, 2013