Endocrine Abstracts

Introduction: Type 1 diabetes (T1D) is the most common metabolic disease in children and adolescents. The transition of care from pediatrics to adult medicine is a real challenge and can be experienced by patients as a huge struggle.

Objective: The objective of this work is to retrospectively study the experience of transition by young type 1 diabetics, in order to shed light on the factors facilitating or hindering this transition.

Materials and Methods: Retrospective study conducted in the endocrinology and diabetology department of the UHC Ibn Rochd, including 60 T1D patients followed in the young adult consultation, referred from the pediatric diabetology department of Harouchi hospital. These patients answered a questionnaire concerning their experience of this transition.

Result: The average age of our patients was 16 years (14-20), with a female predominance (60%), all were on a basal bolus regimen. The average age of diagnosis of diabetes was 7 years. The average age of transition was 14 years old. The announcement of the transition was made by the pediatrician in all our patients. Regarding the feelings of patients at the time of the announcement, 41.6% were curious, 45% worried, 5% refused the transition, and 8.3% had no opinion. The average HbA1c at the time of transition was 8%. At the first young adult consultation, 70% of patients were accompanied by their mother, 25% by their father, 5% came alone. The establishment of trust with the healthcare team was rapid in 60% of patients. The first hospitalization in adult medicine was for diabetic ketosis in 66% of patients (including 70% on insulin withdrawal), severe hypoglycemia in 5%, and for glycemic imbalance in 29%. The average time between the transition and the first hospitalization was 6 months. Regarding the overall experience of the transition in our patients, it was easy and smooth in 40%, difficult in 45%, while 15% did not realize it.

Conclusion: The transition from pediatrics to adult medicine is a critical period for young people with T1D which can be difficult for some, thus causing a glycemic imbalance, or even acute decompensation of their diabetes. Hence the importance of being aware of the factors hindering this transition in order to make it easier, especially during adolescence.