ECE2023 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (159 abstracts)
Transition from childhood to adult care in type 1 diabetes mellitus: Single-center experience
Betül Yiğit Yalçın 1 , Ummahan Tercan 2 , Melek Yıldız 2 , Hulya Hacisahinogullari 1 , Gulsah Yenidunya Yalin 1 , Nurdan Gul 1 , Ozlem Soyluk Selcukbiricik 1 , Ayse Kubat Uzum 1 , Sukran Poyrazooglu 2 , Firdevs Bas 2 , Kubilay Karşıdağ 1 , Ilhan Satman 1 & Feyza Darendeliler 2
1Istanbul University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, istanbul, Turkey; 2Istanbul University Faculty of Medicine, Department of Paediatrics, Division of Paediatrics Endocrinology, istanbul, Turkey
Introduction: Type 1 diabetes mellitus (T1DM) requires lifelong management, and a well-designed protocol may facilitate transition from child-centered healthcare systems to adult-oriented systems.
Aim: We aimed to evaluate sociodemographic data, clinical features and laboratory parameters that may affect the transition period and post-transition process in T1DM patients.
Materials and Methods: We retrospectively analyzed 64 patients with T1DM who were transitioned from pediatric to adult endocrinology outpatient clinic in Istanbul University, Istanbul Faculty of Medicine. Patients were followed up between 2001-2022 and completed their pediatric follow-up and participated in the pediatric-to-adult transition. The patients have been transferred to adult care with two different transition models. In model 1, transition was conducted in a single meeting, in model 2 it was conducted in a 4-6 month period. Demographic data, clinical and metabolic parameters, presence of diabetic complications and comorbidities, and treatment modalities were examined.
Results: Sixty-four patients were included in the analysis (43.7% female, age at diagnosis 9.4±3.9). The mean age at last visit in pediatric care and at transition were 17.3±0.5 and 20.2±1.4 years, respectively. The median time in adult care follow up was 3.3 (min 0.3-20.9) years except for 5 subjects who lost-to-follow-up after one visit, and 4 subjects who were recently transferred. Mean body mass index at the time of transition was 24.1±1.7 kg/m2. While frequency of obesity was 1.6% in last pediatric visit, it increased up to 9.6% in last adult care visit. Use of insulin pump in adult care was higher (4.7% vs 12.5%; P=0.11). Total insulin doses were significantly higher at transition than in last adult care visit (0.95 vs 0.75 IU/kg/day; P<0.01). Basal insulin ratio was higher in adulthood (43.1% vs. 52.8%; P<0.01). Routine control visit per year for diabetes care was higher in pediatrics follow-up (P<0.01). Mean HbA1c was significantly lower in adulthood (8.9% vs. 8.3%; P<0.01). Frequency of autoimmune thyroiditis and coeliac disease did not differ in pediatric and adult care. Although frequency of micro and macrovascular complications increased in adult care, no significant difference was found in acute and chronic complications. There was no difference between transition models 1 and 2 regarding diabetes care.
Conclusion: Obesity has increased in adulthood. Although total insulin doses decreased in adulthood, basal insulin ratio increased. Diabetes control get better in adulthood. Planned transition models have positive impact on diabetes care of adult patients.
Keywords: Type 1 diabetes mellitus, transition, diabetes care
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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