ECEESPE2025 Rapid Communications Rapid Communications 2: Diabetes and Insulin Part 1 (6 abstracts)
Transition of youth with type 1 diabetes from pediatric to adult care in Europe: Insights from centers participating in the international sweet initiative
Barbara Piccini 1 , Reinhard Holl 2 , Carine De Beaufort 3 , Nancy Elbarbary 4 , Christina Kanaka-Gantenbein 5 , Hwa Young Kim 6 , Joseph Leung 7 , Faisal Malik 8 , Jawad Mirza 9 , Lukana Preechasuk 10 , Itxaso Rica 11 , Sonia Toni 1 & Violeta Iotova 12
1Diabetology and Endocrinology Unit, Meyer University children’s Hospital, IRCCS, Florence, Italy; 2University of Ulm, Institute of Epidemiology and Medical biometry, ZIBMT, Ulm, Germany; 3Faculty of Science , Technology and Medicine, University of Luxemburg, Esch -Belval, Luxembourg Pediatric Clinic/Centre Hospitalier de Luxemburg, Luxemburg, Luxembourg; 4Diabetes Unit, Department of Pediatrics, Ain Shams University, Cairo, Egypt; 5Division of Endocrinology, Diabetes and Metabolism Endo-ERN Aghia Sophia Children’s Hospital representative First Department of Pediatrics National and Kapodistrian University of Athens Medical School Aghia Sophia Children’s Hospital, Athens, Greece; 6Division of Pediatric Endocrinology and Metabolism Department of Pediatrics Seoul National University Bundang Hospital 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, South Korea; 7University of British Columbia, Vancouver, Canada; 8Department of Pediatrics, University of Washington School of Medicine, Seattle, United States; 9Pediatric endocrine and diabetic unit Department of pediatrics Mubarak alkabeer hospital Ministry of health, Kuwait City, Kuwait; 10Siriraj Diabetes Center of Excellence, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 11Pediatric Endocrinology Department. Hospital Universitario Cruces. BIOBIZKAIA. CIBERDEM, Bizkaia, Spain; 12Dept. of Pediatrics, Medical University of Varna, Varna, Bulgaria
JOINT2076
Introduction and objective: There is limited understanding of the heterogeneity in transfer of care from pediatric to adult services for youth with type 1 diabetes (T1D).
Aims: This study aims to examine T1D transition among European SWEET centers.
Methods: The SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) database was analyzed (2016-2023, >20 patients,>5-year data). Transfer was assumed in patients 14-24 years without visits for ≥2 years. Age at transfer and sex, metabolic control, BMI-SDS, comorbidity, technology use (pump, continuous glucose monitoring [CGM], closed loop [CL], telemedicine [TM]) were evaluated across Western and Eastern Europe.
Results: 19,123 patients (58 centers) were transferred (51% male, 93% T1D, mean DM duration 7.6 years). The median age at transfer was 18.7 years [Q1-Q3: 17.9-19.6]. Large centers transferred later, at 19.3 years [18.0-22.0], without gender differences. At patient level, the last visit mean age was 17.5 years [Q1-Q3: 13.6-18.9]. Mean HbA1c was 8% [6.9-8.7], BMI-SDS (WHO) 0.5 [-0.2-1.2]; 4% of patients had celiac disease (CD) and 3.8% Hashimoto thyroiditis. 5% of T1D patients were treated by CL, 41% with pump and 46% used CGM. Technology (as telemedicine, CGM, pump) was used by 60% of patients. Compared to patients not transferred (n=23,947), HbA1c was higher (7.6% vs 8%; P<0.0001), without differences in BMI-SDS. T1D females left earlier (-0.13 years; P<0.0001), patients with longer T1D and followed at larger centers left later. CD and thyroiditis did not affect age at transfer. Higher BMI z-score was associated with earlier transfer (-0.07, P<0.0001) as well as worse metabolic control (-0.1, P<0.0001). A model including interactions showed that only metabolic control, center size and diabetes duration remained associated with age at transfer. Pump, CL, CGM users were transferred earlier (-0.2, -0.3, -0.2; P<0.0001), while telemedicine was associated with later transfer (+0.7, P<0.0001). The interaction between technology use, HbA1c and BMI-SDS did not change the results. Age at transfer was similar in East and West Europe, with some differences in transition-related factors. For West Europe CGM was not associated to age at transfer. Considering East Europe, gender and metabolic control didn’t affect age at transfer, while CL and technology use were associated with earlier transfer (-0.1, p 0.03).
Conclusion: This study highlights the significant heterogeneity of age at transfer of youth with T1D across Europe and some notable differences between European regions that warrant further exploration.
Volume 110
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