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Exp Clin Endocrinol Diabetes 2023; 131(10): 532-538
DOI: 10.1055/a-2132-9585
Article

Transition From Childhood to Adult Care in Patients with Type 1 Diabetes: 20 Years of Experience From the Tübinger Transition Study

Roland Schweizer 
1   Pediatric Diabetology, University Children’s Hospital, Tübingen, Germany
,
Martina Lösch-Binder
1   Pediatric Diabetology, University Children’s Hospital, Tübingen, Germany
,
Clara Hayn
1   Pediatric Diabetology, University Children’s Hospital, Tübingen, Germany
,
Silas Friz
1   Pediatric Diabetology, University Children’s Hospital, Tübingen, Germany
,
Julia Uber
1   Pediatric Diabetology, University Children’s Hospital, Tübingen, Germany
,
Julian Ziegler
1   Pediatric Diabetology, University Children’s Hospital, Tübingen, Germany
,
Franziska Liebrich
1   Pediatric Diabetology, University Children’s Hospital, Tübingen, Germany
,
Andreas Neu
1   Pediatric Diabetology, University Children’s Hospital, Tübingen, Germany
› Author Affiliations Funding Information Deutsche Diabetes Gesellschaft — http://dx.doi.org/10.13039/501100010215; DDG-Projektförderung
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Abstract

Aims Transition from pediatric to adult care is difficult for patients with chronic diseases. In this study, factors associated with metabolic control in childhood-onset type 1 diabetes (T1D) after transfer to adult care were analyzed.

Methods Overall, 224 persons with T1D were contacted yearly from 1998 to 2019. They voluntarily answered a questionnaire about their current hemoglobin A1c (HbA1c) levels, diabetes-associated complications, kind of care, living conditions, and family situation. Then, mixed longitudinal-cross-sectional analyses were carried out.

Results Overall, 190 patients answered at least once (mean age: 26.6 years). Diabetes complications were mentioned by 10 patients (5 microalbuminuria, 5 retinopathy). Most patients (92.6%) were in diabetes-specific care during the first year after transfer, with a trend to leave diabetes-specific care during the observation period. Patients in diabetes-specific care displayed lower HbA1c levels (%/mmol/mol) (7.1/54 vs. 7.5/58). An important predictor for HbA1c after transfer was HbA1c during the year before transfer (r=0.67, p <0.001). Patients living alone showed no difference in HbA1c levels from those living with their parents. Married patients had lower HbA1c levels (7.0/53 vs. 7.3/56, p<0.05) than unmarried ones. Patients with children (15.8%) presented lower HbA1c levels (6.9/52 vs. 7.3/56, p <0.01) than those without.

Conclusions Good metabolic results are favored in patients followed-up in specialized care, are married, and are parents. We recommend transfer to a diabetologist with experience in T1D at an individual age.

Key words

diabetes care - type 1 diabetes - diabetic control - family situation - HbA1c - transition


Publication History

Received: 20 March 2023
Received: 14 July 2023

Accepted: 17 July 2023

Accepted Manuscript online:
19 July 2023

Article published online:
07 September 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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