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

Details

• Alternative Title:
  Diabet Med
• Personal Author:
  Agarwal, S. ; Raymond, J. K. ; Isom, S. ; Lawrence, J. M. ; Klingensmith, G. ; Pihoker, C. ; Corathers, S. ; Saydah, S. ; D’Agostino, R. B. ; Dabelea, D.
• Description:
  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.
  
  
• Subjects:
  Article
• Source:
  Diabet Med. 35(4):504-512.
• Pubmed ID:
  29377258
• Pubmed Central ID:
  PMC6130201
• Document Type:
  Journal Article
• Funding:
  P30 DK057516/DK/NIDDK NIH HHS/United States ; U18DP006139/ACL HHS/United States ; UC4 DK108173/DK/NIDDK NIH HHS/United States ; U01 DP000247/DP/NCCDPHP CDC HHS/United States ; U18 DP003256/DP/NCCDPHP CDC HHS/United States ; U18 DP006131/DP/NCCDPHP CDC HHS/United States ; U18 DP002710/DP/NCCDPHP CDC HHS/United States ; U18 DP006134/DP/NCCDPHP CDC HHS/United States ; U18 DP006138/DP/NCCDPHP CDC HHS/United States ; U18DP006138/ACL HHS/United States ; UL1 TR000154/TR/NCATS NIH HHS/United States ; U18 DP002714/DP/NCCDPHP CDC HHS/United States ; U01 DP000248/DP/NCCDPHP CDC HHS/United States ; U18 DP006136/DP/NCCDPHP CDC HHS/United States ; U01 DP000244/DP/NCCDPHP CDC HHS/United States ; U18DP006134/ACL HHS/United States ; U18 DP002709/DP/NCCDPHP CDC HHS/United States ; U18 DP006133/DP/NCCDPHP CDC HHS/United States ; U18DP006131/ACL HHS/United States ; UL1 TR001425/TR/NCATS NIH HHS/United States ; U18 DP006139/DP/NCCDPHP CDC HHS/United States ; UL1 TR000423/TR/NCATS NIH HHS/United States ; U18DP006136/ACL HHS/United States ; U01 DP000250/DP/NCCDPHP CDC HHS/United States ; U01 DP000246/DP/NCCDPHP CDC HHS/United States ; UL1 TR001450/TR/NCATS NIH HHS/United States ; U01 DP000254/DP/NCCDPHP CDC HHS/United States ; U18DP006133/ACL HHS/United States ; U18 DP002708/DP/NCCDPHP CDC HHS/United States
• Volume:
  35
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:cff08e1f640844b7db155b739cee2bedf7ad99d32f3242d4cd855e6b5f1a678c
• Download URL:
  https://stacks.cdc.gov/view/cdc/58863/cdc_58863_DS1.pdf
• File Type:
  [PDF - 431.93 KB ]