Endocrine Abstracts

JOINT1910

Introduction: The transition of type 1 diabetic patients from pediatric to adult care represents a real challenge in diabetes consultations, highlighting the importance of effectively ’bridging the gap. The aim of our work was to evaluate the impact of this transition on glycemic control.

Methods: A retrospective observational study including type 1 diabetic patients who were followed in the department C of the children’s hospital and then referred to the transition consultations organized within department B of the National Institute of Nutrition between 2018 and 2023. Each transition consultation involved an endocrinologist, a nutritionist, and a nurse.

Results: The study included 28 type 1 diabetic patients. Fifty-three percent of the patients were male. The average age at the time of transition was 16 years ± 2 [11-21 years]. The average duration of diabetes was 10 years ± 4 [1-15 years]. Half of the diabetic patients were not on a complete basal-bolus regimen. Sixty-one percent of the patients were overdosed on basal insulin (with an average dose of 0.59 IU/kg), and 23% experienced frequent hypoglycemia. The average HbA1c at the time of transition was 10.2% ± 1.5 [8.2; 13.5]. Eighty-eight percent of patients consulted regularly after the transition. Half of the patients experienced a significant improvement in HbA1c after 6 months, with an average decrease of 1.7%. Additionally, 27% of patients continued to improve after 12 months, with an average HbA1c improvement of 2% compared to the baseline.

Conclusion: The care transition for diabetic patients faces the complexity of managing the disease during a phase characterized by multiple physical, psychological, and social changes. A structured approach, including therapeutic education and psychological support, must be implemented to prevent interruptions in care (care gap), ensure continuity, and successfully manage this transition.