Health care transition preparation and experiences in a U.S. National sample of young adults with type 1 diabetes

Katharine C. Garvey, Nicole C. Foster, Shivani Agarwal, Linda A. DiMeglio, Barbara J. Anderson, Sarah D. Corathers, Marisa E. Desimone, Ingrid M. Libman, Sarah K. Lyons, Anne L. Peters, Jennifer K. Raymond, Lori M. Laffel

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

OBJECTIVE Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. We developed a survey to evaluate transition experiences in two groups of young adults with type 1 diabetes, before (PEDS) and after (ADULT) transition to adult care. RESEARCH DESIGN AND METHODS We fielded an electronic survey to young adults (18 to <30 years) at 60 T1D Exchange Clinic Registry centers. RESULTS Surveys were completed by 602 young adults, 303 in the PEDS group (60% female, age 20 6 2 years) and 299 in the ADULT group (62% female, age 24 6 3 years). In the PEDS group, mean anticipated transition age was 22 62 years; 64% remained in pediatric care because of emotional attachment to the provider. The ADULT group transitioned at age 19 6 2 years, mainly after pediatric provider recommendation. More than 80% of respondents reported receiving counseling on type 1 diabetes self-management and screening tests from pediatric providers, but less than half (43% PEDS and 33% ADULT) reported discussing reproductive health. In the PEDS group, half had discussed transfer with pediatric providers. Of the ADULT participants, 63% received an adult provider referral, and 66% felt mostly/completely prepared to transition. ADULT participants with fewer pretransition pediatric visits orwho felt unprepared for transition had increased odds of gaps >6 months between pediatric and adult care. Receipt of transition preparation counseling was not associated with self-reported hemoglobin A1c <7.0% in either group. CONCLUSIONS These results support the need for intensive efforts to integrate transition preparation counseling and care coordination into pediatric type 1 diabetes care .

Original languageEnglish (US)
Pages (from-to)317-324
Number of pages8
JournalDiabetes care
Volume40
Issue number3
DOIs
StatePublished - Mar 1 2017
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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    Garvey, K. C., Foster, N. C., Agarwal, S., DiMeglio, L. A., Anderson, B. J., Corathers, S. D., Desimone, M. E., Libman, I. M., Lyons, S. K., Peters, A. L., Raymond, J. K., & Laffel, L. M. (2017). Health care transition preparation and experiences in a U.S. National sample of young adults with type 1 diabetes. Diabetes care, 40(3), 317-324. https://doi.org/10.2337/dc16-1729