ECEESPE2025 Poster Presentations Diabetes and Insulin (143 abstracts)
Multidisciplinary team transition model of care for type 1 diabetes: health outcomes after 2 years of implementation
Teresa Tavares 1 , Ana Torrão Pinheiro 2 , Catarina Figueiredo 3 , Catarina Mendes 3 , Carla Rocha 4 , Tiago Santos 2 , Susana Garrido 2 , Joana Freitas 3 , Sofia Teixeira 2 , Teresa Borges 3 , Joana Vilaverde 2 & Maria João Oliveira 3
1Centro Hospitalar Universitário de Santo António, Pediatrics Department, Porto, Portugal; 2Centro Hospitalar Universitário Santo António, Endocrinology Department, Porto, Portugal; 3Centro Hospitalar Universitário Santo António, Pediatric Endocrinology, Porto, Portugal; 4Centro Hospitalar Universitário Santo António, Porto, Portugal
JOINT3710
Introduction: The transition of young adults with type 1 diabetes mellitus (T1DM) is challenging for the young person, their families and health care providers. They must assume higher levels of autonomy and often neglect their healthcare. For a more successful change of care, structured transition programs are necessary. Our aims are to characterize T1DM patients who went from pediatric to adult care in the last 2 years, evaluate their glycemic control over time, and the occurrence of acute complications.
Methods: The transition model adopted in our center consists of a multidisciplinary team that includes nurses, the pediatric endocrinologist, and the adult endocrinology team. Data regarding demographic characteristics, time since diagnosis, glycemic control, and complications was collected from electronic clinical files. Glycemic control was evaluated using HbA1c, glucose management indicator (GMI), coefficient of variation (CV), time in range (TIR) and time below range (TBR), at 6 months intervals.
Results: 25 patients with T1DM had transition appointments in the last 2 years, 40% female, median age at diagnosis 11 years and at transition 19 years. Median time since diagnosis at transition of 8 years. All had continuous subcutaneous insulin infusion (CSII), 80% had continuous glucose monitoring. 76% are currently enrolled in higher education. No patient was lost to follow-up, and all are still with CSII, 24% changed to automated insulin delivery (AID) systems. There was 1 hospitalization for ketoacidosis (around 12 months after transition), with no previous serious acute complications. There was a statistically significant worsening of HbA1c (P < 0. 001), GMI (P = 0. 001) and TIR (P < 0. 001) 6 months after transition. GMI values improved 18 months after transition (P = 0. 027).
| 6 months before transition | At transition | 6 months after transition | 12 months after transition | 18 months after transition | 24 months after transition | |
| N | 25 | 25 | 24 | 15 | 12 | 5 |
| HbA1c | 7. 3% | 7. 5% | 8. 1% | 9. 2% | 7. 4% | 7. 2% |
| GMI | 7. 2% | 7. 5% | 8. 1% | 8% | 7. 6% | 7% |
| CV | 40. 9% | 40. 9% | 39. 6% | 39. 4% | 37. 3% | 34. 2% |
| TAR | 38. 7% | 46. 1% | 47. 8% | 48. 5% | 39. 1% | 28. 4% |
| TIR | 55% | 48. 8% | 47. 2% | 45. 4% | 54. 8% | 68. 6% |
| TBR | 6. 2% | 5. 5% | 4. 9% | 3. 9% | 3. 3% | 3% |
Discussion: Our center’s transition model for T1DM patients has been successful, with no losses to follow-up. Only one showed a serious acute complication. Glycemic control worsened initially after transition, with a subsequent improvement after 18 months, that seems to extend into the 24-month mark, which might reflect their increasing autonomy in self-care, reinforcing the need for therapeutic re-education aimed at young adults.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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