Endocrine Abstracts

Background: Transition can be a difficult time for adolescents with chronic diseases leading to poor attendance in adult clinics and poor long-term health outcomes. The implementation of transition programmes like ‘ReadySteadyGo’ at University Hospital Southampton (UHS) aim to improve transitional care and outcomes for patients.

Aims: To assess the effect of a structured transition programme, ‘Go’ from ‘ReadySteadyGo’, at UHS for patients with Type 1 diabetes.

Method: The cohort consisted of patients transitioned from paediatrics at UHS during 2011–2014, aged 17–19 yrs at transition (n=74). Group 1 transitioned during 2011 (n=25) receiving no structured transition: group 2 transitioned during 2012 and onwards (n=49) and received a structured transition programme, ‘Go’.

Results: The average HbA1c of the cohort before transition was 9.6% (S.D. 2.1). After transition mean HbA1c in the cohort rose to 10.1% (S.D. 2.4, P=0.026). HbA1c in group 1 did not significantly increase after transition; in group 2 HbA1c rose 1.5% (P=0.035).

Patients attended on average 1 appointment less after transition however attendance as a percentage of appointments offered increased from 51% (S.D. 0.03) before transition to 73% (S.D. 0.04) after(P<0.001). Attendance was better after transition in group 2 (74% vs 69% respectively). The percentage of documented conversations about contraception in girls before transition rose from 46%(S.D. 0.52) in group 1–79%(S.D. 0.42) in group 2 (P=0.02). Looking at diabetes related hospital admissions after transition, 84% (S.D. 0.07) were in those who had an HbA1c >10% before transition.

Conclusions: HbA1c at the beginning of ‘Go’ around 16 yrs of age was already high, and attendance in clinic was poor suggesting that transition programmes need to be implemented earlier. The implementation of a structured transition programme improved attendance in adult clinics and education around family planning in Type 1 diabetes. The implementation of the full “ReadySteadyGo” programme from 11 yrs will aim to continue improving transition outcomes at UHS.