Endocrine Abstracts

Introduction: ‘Transition’ is the period of movement from paediatric to adult healthcare. These patients are in their adolescence when the brain is maturing, causing changes in behaviors including greater risk-taking. The period of transition can be associated with poor adherence to insulin and blood glucose monitoring regimens and an increased risk of diabetic ketoacidosis (DKA). This study looks into how effective our transition programme has been at addressing this.

Method: We have assessed the outcomes of diabetes transition healthcare from 2013–2017 by looking at attendance at appointments, HbA1C levels and emergency admissions for hypoglycaemia, overdose, insulin omission and DKA. We studied 60 patients, within the age range of 16–19 years, previously diagnosed with Type 1 or Type 2 diabetes and who had continued to attend the young adult service after transition clinic.

Results: Out of the 60 patients studied 36 were female. The mean age when they first attended transition clinic was 17.5 years. Duration of transition spanned from 0-21 months with a mean duration of 7.8 months. A mean of 3 appointments were offered and a mean of 2 were attended. The overall attendance rate to transition clinic was 63%. Two out of the 60 patients attended no appointments in transition clinic. The table below depicts the HbA1C values before the first transition appointment and one year after the last transition appointment. Emergency admissions shown include all records outside of the transition period, excluding new diagnoses of diabetes.

Conclusion: Diabetes control, measured by HbA1C, deteriorates post-transition. 87.5% of all young people completing transition had a recorded HbA1C one year post-transition, showing they were still engaged with the adult services. Admission rates also increase for DKA (albeit affecting the same 4 patients with recurrent DKA pre-transition). Improving support for young people in the young adult service is imperative to improve outcomes.