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Diabetologia

Erschienen in:

13.01.2021 | Article

Improved transition to adult care in youth with type 1 diabetes: a pragmatic clinical trial

verfasst von: Sonia Butalia, Susan G. Crawford, K. Ashlee McGuire, David K. Dyjur, Julia R. Mercer, Danièle Pacaud

Erschienen in: Diabetologia | Ausgabe 4/2021

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Abstract

Aims/hypothesis

Youth with type 1 diabetes are at high risk for loss to follow-up during the transition from paediatric to adult diabetes care. Our aim was to assess the effect of a communication technology enhanced transition coordinator intervention compared with usual care on clinic attendance among transitioning youth with type 1 diabetes.

Methods

In this open label, pragmatic clinical trial of youth with type 1 diabetes, aged 17–18 years, transitioning from paediatric to adult diabetes care, the intervention group received support from a transition coordinator who used communication technology and the control group received usual care. The primary outcome was the proportion of individuals that did not attend at least one routine clinic visit in adult diabetes care within 1 year after transfer. Secondary outcomes included diabetes-related clinical outcomes and quality of life measures.

Results

There were no baseline differences in age, sex, HbA_1c and number of follow-up visits, emergency department visits and diabetic ketoacidosis admissions in the 1 year prior to transition between the usual care (n = 101) and intervention (n = 102) groups. In the year following transfer, 47.1% in the usual care group vs 11.9% in the intervention group did not attend any outpatient diabetes appointments (p < 0.01). There were no differences in glycaemic control or diabetic ketoacidosis post transfer.

Conclusions/interpretation

Our intervention was successful in improving clinic attendance among transitioning youth with type 1 diabetes. Importantly, this programme used simple, readily accessible communication technologies, which increases the sustainability and transferability of this strategy.

Trial registration

isrctn.org ISRCTN13459962

Graphical abstract

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Titel: Improved transition to adult care in youth with type 1 diabetes: a pragmatic clinical trial
verfasst von: Sonia Butalia
Susan G. Crawford
K. Ashlee McGuire
David K. Dyjur
Julia R. Mercer
Danièle Pacaud
Publikationsdatum: 13.01.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Diabetologia / Ausgabe 4/2021
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-020-05368-1

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Abstract

Aims/hypothesis

Methods

Results

Conclusions/interpretation

Trial registration

Graphical abstract

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