Glycaemic control and diabetes care utilization in young adults with Type 1 diabetes

Diabet Med. 2008 Aug;25(8):968-73. doi: 10.1111/j.1464-5491.2008.02521.x.

Abstract

Objectives: To explore how glycaemic control in young adults is related to diabetes care utilization during the transition to adult diabetes care and if these variables differ between males and females.

Methods: This is a retrospective, longitudinal design following patients' records from age 18-24 years. Adolescents (n = 104) connected to one paediatric outpatient clinic and referred to six different adult clinics were included. Data were collected regarding gender, age at diagnosis and transfer, yearly glycated haemoglobin (HbA(1c)) and body mass index, severe hypoglycaemia and diabetic ketoacidosis, retinopathy and diabetes care utilization.

Results: HbA(1c) decreased over time in females (P = 0.004) but not in males. Less than 10% had HbA(1c) in the recommended range during the study period. The decrease in severe hypoglycaemia and diabetic ketoacidosis was not significant. The prevalence of background retinopathy increased from 5 to 29% during the study period (P < 0.001). Mean transfer age was 19.8 years. The youths visited the paediatric clinic more often than the adult clinic (P < 0.001) and females visited adult care more often than males (P = 0.04). There was a steady decrease in the number of visits/year over time (P < 0. 001). Poor glycaemic control was associated with more visits for both males and females (P = 0.005) in adult care.

Conclusions: As there was no gender difference in the relation between HbA(1c) and the number of visits in adult diabetes care, the higher frequency of visits in adult care for females cannot be solely explained by their glycaemic control. Gender differences regarding diabetes care utilization should be further explored.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Glucose / metabolism*
  • Delivery of Health Care / standards*
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / therapy*
  • Disease Management
  • Female
  • Glycated Hemoglobin A / metabolism*
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / therapy*
  • Longitudinal Studies
  • Male
  • Practice Guidelines as Topic
  • Retrospective Studies
  • Statistics as Topic
  • Young Adult

Substances

  • Blood Glucose
  • Glycated Hemoglobin A