Introduction: Transition from child to adult healthcare is a period of vulnerability for young people with diabetes. We hypothesised that patient satisfaction with services and patient wellbeing would be positively associated with a satisfactory clinical progression.
Methods: We included data from 150 young people recruited in 2012 to a longitudinal study of transition (http:research.ncl.ac.uk/transition). Young peoples satisfaction with services (Mind the Gap) and patient mental wellbeing (Warwick and Edinburgh Mental Well being instrument or WEMWBS) were assessed at baseline and annually for 3 years in 5 diabetes units in England; 108/150 (72%) remained in the study to the final visit. Following collaborator discussion and literature review, a composite measure of satisfactory clinical outcome was constructed according to change in HbA1c (< 7% increase in HbA1c from baseline), episodes of diabetic ketoacidosis (none), attendance at clinic (> 75%) and attendance at annual retinal screening appointments (100%).
Results: The median age of young people at study entry was 16.0 years (IQR 1.27). The HbA1c at baseline was comparable to the National Paediatric Diabetes audit 2011/12. Young peoples HbA1c increased from a median of 69 mmol/l, year 1, to 75 mmol/l, year 4. The WEMWBS score was comparable to population studies at study entry and was stable over the study duration. The Mind the Gap score was also stable throughout. By study end, 32 individuals had satisfactory clinical outcome and 76 a suboptimal outcome. The two groups were comparable in terms of age, duration of diabetes, and baseline HbA1c. There were no differences in median satisfaction with services and WEMWBS scores in either group.
Conclusion: Mental well-being in young people with diabetes is similar to the population as a whole and did not change during transition. Two thirds of the study population had a sub-optimal clinical progression after transition which was not related to wellbeing or satisfaction scores.
This abstract presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0610-10112). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
22 - 24 Nov 2017
British Society for Paediatric Endocrinology and Diabetes