Transition process of patients with type 1 diabetes (T1DM) from paediatric to the adult health care service: a hospital-based approach

  1. F. Cadario1,
  2. F. Prodam1,2,
  3. S. Bellone1,
  4. M. Trada1,
  5. M. Binotti1,
  6. M. Trada1,
  7. G. Allochis3,
  8. R. Baldelli4,
  9. S. Esposito1,
  10. G. Bona1,
  11. G. Aimaretti2,3

Article first published online: 3 NOV 2008

DOI: 10.1111/j.1365-2265.2008.03467.x

Issue

Clinical Endocrinology

Clinical Endocrinology

Volume 71, Issue 3, pages 346–350, September 2009

Additional Information

How to Cite

Cadario, F., Prodam, F., Bellone, S., Trada, M., Binotti, M., Trada, M., Allochis, G., Baldelli, R., Esposito, S., Bona, G. and Aimaretti, G. (2009), Transition process of patients with type 1 diabetes (T1DM) from paediatric to the adult health care service: a hospital-based approach. Clinical Endocrinology, 71: 346–350. doi: 10.1111/j.1365-2265.2008.03467.x

Author Information

  1. 1

    SCDU of Paediatrics, Department of Medical Science, University of Eastern Piedmont, Novara, Italy,

  2. 2

    Division of Endocrinology, Department of Clinical and Experimental Medicine, University of Eastern Piedmont, Novara, Italy,

  3. 3

    SCDO Metabolic Diseases and Diabetology, Azienda Ospedaliero-Universitaria Maggiore delle Carità, Novara, Italy and

  4. 4

    Endocrinology Service, IRCCS Regina Elena Cancer Institute, Rome, Italy

*Francesco Cadario, SCDU of Paediatrics, ‘Maggiore della Carità’ Hospital, C.so Mazzini 18, 28100 Novara, Italy. Tel.: +39 0321 3733793; Fax: +39 0321 373 3598; E-mail: francesco.cadario@maggioreosp.novara.it

Publication History

  1. Issue published online: 14 AUG 2009
  2. Article first published online: 3 NOV 2008
  3. (Received 22 June 2008; returned for revision 2 September 2008; finally revised 20 October 2008; accepted 24 October 2008)

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (268K)

Summary

Introduction  The outcomes of different types of transitions of young people with chronic diseases have been poorly investigated.

Objective  To evaluate and compare a structured transition from the paediatric diabetes services (PDS) into the adult diabetic services (ADS) with an unstructured one.

Design  We retrospectively investigated 62 adolescents and young adults with type 1 diabetes discharged from the PDS from 1 January 1994 to 31 December 2004. Thirty-two patients (group A) were transferred to the ADS of the same hospital with an unstructured method (letter) and 30 patients after a structured transfer planned with adult physicians (group B). We analysed the date of the first admission in ADS, the glycated haemoglobin (HbA1c), the clinic attendance rate in PDS and in the first year in ADS, and a phone questionnaire on the transition experience.

Results  The duration of the transfer was longer in A than in B with a lack of medical assistance during the unstructured transition (P < 0·001). At the first visit in ADS, before any medical intervention, HbA1c was improved in B compared to the last in PDS (P < 0·01), and had a trend in worsening in A. After 1 year in the ADS there was a better clinical attendance, and a lower HbA1c in B than in A (P < 0·05). All the subjects of group B reported a favourable opinion for the structured transition (P < 0·0001).

Conclusion  The transition process plays an important role in diabetic care and a structured plan is mandatory to avoid to lose the patients and to get worse their health.

View Full Article (HTML) Get PDF (268K)