Transfer from paediatric to adult care for young adults with Type 2 diabetes: the SEARCH for Diabetes in Youth Study

S. Agarwal, J. K. Raymond, S. Isom, J. M. Lawrence, G. Klingensmith, C. Pihoker, S. Corathers, S. Saydah, R. B. D'Agostino, D. Dabelea

Research output: Contribution to journalArticle

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Abstract

Aim: To describe factors associated with transfer from paediatric to adult care and poor glycaemic control among young adults with Type 2 diabetes, using the SEARCH for Diabetes in Youth study. Methods: Young adults with Type 2 diabetes were included if they had a baseline SEARCH visit while in paediatric care at < 18 years and ≥ 1 follow-up SEARCH visit thereafter at 18–25 years. At each visit, HbA 1c , BMI, self-reported demographic and healthcare provider data were collected. Associations of demographic factors with transfer of care and poor glycaemic control (HbA 1c ≥ 75 mmol/mol; 9.0%) were explored with multivariable logistic regression. Results: 182 young adults with Type 2 diabetes (36% male, 75% minority, 87% with obesity) were included. Most (n = 102, 56%) reported transfer to adult care at follow-up; a substantial proportion (n = 28, 15%) reported no care and 29% did not transfer. Duration of diabetes [odds ratio (OR) 1.4, 95% confidence interval (95% CI) 1.1, 1.8] and age at diagnosis (OR 1.8, 95% CI 1.4, 2.4) predicted leaving paediatric care. Transfer to adult or no care was associated with a higher likelihood of poor glycaemic control at follow-up (adult: OR 4.5, 95% CI 1.8, 11.2; none: OR 4.6, 95% CI 1.4, 14.6), independent of sex, age, race/ethnicity or baseline HbA 1c level. Conclusions: Young adults with Type 2 diabetes exhibit worsening glycaemic control and loss to follow-up during the transfer from paediatric to adult care. Our study highlights the need for development of tailored clinical programmes and healthcare system policies to support the growing population of young adults with youth-onset Type 2 diabetes.

Original languageEnglish (US)
Pages (from-to)504-512
Number of pages9
JournalDiabetic Medicine
Volume35
Issue number4
DOIs
StatePublished - Apr 2018
Externally publishedYes

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Transition to Adult Care
Type 2 Diabetes Mellitus
Young Adult
Odds Ratio
Confidence Intervals
Demography
Pediatrics
Health Personnel
Obesity
Logistic Models
Delivery of Health Care
Population

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Agarwal, S., Raymond, J. K., Isom, S., Lawrence, J. M., Klingensmith, G., Pihoker, C., ... Dabelea, D. (2018). Transfer from paediatric to adult care for young adults with Type 2 diabetes: the SEARCH for Diabetes in Youth Study. Diabetic Medicine, 35(4), 504-512. https://doi.org/10.1111/dme.13589

Transfer from paediatric to adult care for young adults with Type 2 diabetes : the SEARCH for Diabetes in Youth Study. / Agarwal, S.; Raymond, J. K.; Isom, S.; Lawrence, J. M.; Klingensmith, G.; Pihoker, C.; Corathers, S.; Saydah, S.; D'Agostino, R. B.; Dabelea, D.

In: Diabetic Medicine, Vol. 35, No. 4, 04.2018, p. 504-512.

Research output: Contribution to journalArticle

Agarwal, S, Raymond, JK, Isom, S, Lawrence, JM, Klingensmith, G, Pihoker, C, Corathers, S, Saydah, S, D'Agostino, RB & Dabelea, D 2018, 'Transfer from paediatric to adult care for young adults with Type 2 diabetes: the SEARCH for Diabetes in Youth Study', Diabetic Medicine, vol. 35, no. 4, pp. 504-512. https://doi.org/10.1111/dme.13589
Agarwal, S. ; Raymond, J. K. ; Isom, S. ; Lawrence, J. M. ; Klingensmith, G. ; Pihoker, C. ; Corathers, S. ; Saydah, S. ; D'Agostino, R. B. ; Dabelea, D. / Transfer from paediatric to adult care for young adults with Type 2 diabetes : the SEARCH for Diabetes in Youth Study. In: Diabetic Medicine. 2018 ; Vol. 35, No. 4. pp. 504-512.
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AU - Isom, S.

AU - Lawrence, J. M.

AU - Klingensmith, G.

AU - Pihoker, C.

AU - Corathers, S.

AU - Saydah, S.

AU - D'Agostino, R. B.

AU - Dabelea, D.

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N2 - Aim: To describe factors associated with transfer from paediatric to adult care and poor glycaemic control among young adults with Type 2 diabetes, using the SEARCH for Diabetes in Youth study. Methods: Young adults with Type 2 diabetes were included if they had a baseline SEARCH visit while in paediatric care at < 18 years and ≥ 1 follow-up SEARCH visit thereafter at 18–25 years. At each visit, HbA 1c , BMI, self-reported demographic and healthcare provider data were collected. Associations of demographic factors with transfer of care and poor glycaemic control (HbA 1c ≥ 75 mmol/mol; 9.0%) were explored with multivariable logistic regression. Results: 182 young adults with Type 2 diabetes (36% male, 75% minority, 87% with obesity) were included. Most (n = 102, 56%) reported transfer to adult care at follow-up; a substantial proportion (n = 28, 15%) reported no care and 29% did not transfer. Duration of diabetes [odds ratio (OR) 1.4, 95% confidence interval (95% CI) 1.1, 1.8] and age at diagnosis (OR 1.8, 95% CI 1.4, 2.4) predicted leaving paediatric care. Transfer to adult or no care was associated with a higher likelihood of poor glycaemic control at follow-up (adult: OR 4.5, 95% CI 1.8, 11.2; none: OR 4.6, 95% CI 1.4, 14.6), independent of sex, age, race/ethnicity or baseline HbA 1c level. Conclusions: Young adults with Type 2 diabetes exhibit worsening glycaemic control and loss to follow-up during the transfer from paediatric to adult care. Our study highlights the need for development of tailored clinical programmes and healthcare system policies to support the growing population of young adults with youth-onset Type 2 diabetes.

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