Adult care ‘improves young people’s glycaemic control’

By Editor
9th February 2017
Good practice, Lead stories Paediatrics Research

A study looking at transitional diabetes care from paediatric to adult has shown glycaemic control improves significantly once the transfer is complete.

However, the research which looked at 126 young people also showed the mean HbA1c levels still remained high.

The participants of the cohort study were aged between 14 and 22 and they were measured from two years before and two years after moving into adult diabetes care.

Their changes in glycaemic control were calculated using repeated measurements and adjustments were made for gender, age at diabetes onset, age at transfer, duration of diabetes at transfer, gap (amount of time) between last paediatric and first adult visit, comorbidity, learning disability and/or mental health conditions and family structure.

Attendance rate

Links between acute hospital admissions, low visit attendance rate, loss to follow-up and baseline HbA1c levels were also looked at.

The mean HbA1c level was 80 mmol/mol (9.4 per cent) pre-transfer, but decreased by an average of 3 mmol/mol (0.3 per cent) each year post-transfer (P = 0.005).

Young people with a learning disability and/or a mental health condition had worse glycaemic control (P = 0.041) and the mean HbA1c of those with divorced parents was 14 mmol/mol (1.2 per cent) higher (P = 0.014).

Almost one-third of participants were admitted to the hospital for acute diabetes care.

Low visit attendance rate, high baseline HbA1c level, learning disability and/or mental health conditions and divorced parents predicted acute hospital admissions.

The authors concluded: “Future interventions should focus on young people with divorced parents, those with a learning disability and/or mental health condition and those who do not attend clinical visits to improve HbA1c levels and thereby reduce hospitalization rates.”

The research was led by Pernille Castsensoee-Seidenfaden from the Paediatric and Adolescent Department, Nordsjællands Hospital in Denmark.

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