Journal of diabetes 2017 02 08() doi 10.1111/1753-0407.12536
Type 1 diabetes is a common chronic disease. Poor health outcomes are often noted after transfer to adult health care. It is important to determine the predictors of such outcomes to decrease the morbidity and mortality.
This retrospective study included patients followed ≥1year pre-transfer and ≥1 year post-transfer to adult care in a Canadian tertiary diabetes center. Data including demographics, education, comorbidity and pediatric diabetes management-related factors were analyzed as possible independent predictors of adult HbA1c, number of adult diabetes-related hospitalization and clinic visits.
A total of 102 youth were followed to a mean age of 21.8 ± 1.5 years. Predictors of mean adult HbA1c were presence of any comorbidity (0.71%; 95%CI 0.15-1.27; p = 0.01), and pediatric HbA1c (0.67% per 1%; 95%CI 0.51-0.84; p < 0.001). Predictors of hospitalization for hyperglycemia were history of pediatric hospitalization for hyperglycemia (IRR=1.20; 95%CI 1.02-1.41; p = 0.029) and high school vs. university education (IRR=3.13; 95%CI 1.12-8.73; p = 0.030). CONCLUSION
Young adults with complicated health histories and less education are more likely to experience poor diabetes outcomes in the years after transfer to adult care. These features may highlight youth requiring closer attention, or may be targets for intervention.