Focussing on engagement provides an opportunity for equity of outcomes: no deterioration in glycaemic outcomes in young people aged 15 to 25 years

Astha Soni; Jackie Elliott

doi:10.1530/endoabs.111.P19

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Endocrine Abstracts (2025) 111 P19 | DOI: 10.1530/endoabs.111.P19

BSPED2025 Poster Presentations Diabetes 1 (9 abstracts)

Focussing on engagement provides an opportunity for equity of outcomes: no deterioration in glycaemic outcomes in young people aged 15 to 25 years

Astha Soni ¹ & Jackie Elliott ²

Author affiliations

¹Sheffield Children’s Hospital NHS Foundation Trust, Sheffield, United Kingdom; ²Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

Introduction: Adolescence and young adulthood have traditionally been associated with significant deteriorations in glycaemic outcomes, and lower engagement in young people (YP) with type 1 diabetes (T1D).

Objectives: In our city paediatric and adult diabetes teams have held combined transition clinics for 16 to 25 year (y) olds for over a decade. We have prioritised engagement alongside biomedical outcomes. In this study we evaluate glycaemic outcomes across the lifespan.

Methods: Data up to the end of December 2024, of 256 children attending a paediatric hospital, and 2,882 adults attending the corresponding adult hospital were analysed, and latest mean ± SD and median HbA1cs calculated.

Results: The mean age (y) ± SD, and duration of T1D (y) ± SD of children 0-14 y (n = 180) was 10.1 ± 3.4 and 4.4 ± 3.3, in YP 15-25 y (n = 486) 20.7 ± 3.0 and 10.2 ± 5.6, and in adults ≥ 26 y (n = 2472) 50.5 ± 15.6 and 25.6 ± 15.7. Engagement was high in all 3 groups, with 99.9%, 95.5% and 92.8% of children, YP and adults respectively having an HbA1c recorded in 2024. Children were more likely to be on HCL, 85.6%, and more YP were on HCL than adults, 56.9% versus 20.1%, P < 0.05. In children aged ≤ 14 y, the HbA1c mean ± SD was 54.2 ± 8.6, compared to 62.0 ± 18.5 in YP aged 15 to 25 y, and 64.1 ± 16.5 in adults aged ≥ 26 y. The corresponding medians for children, YP and adults were 53, 57 and 61 respectively. HbA1c outcomes are stable until the age of 12, then increased, before plateauing from the age of 15 to 26.

Conclusions: Engaging young people with T1D in specialist diabetes care throughout transition is of paramount importance. By designing a service according to their needs, they know they are always welcome, attendance rates are high and the service can offer the latest technological advances. We have reduced the magnitude and the number of years over which glycaemic deterioration is usually observed in adolescence and young adulthood, meaning more young people can expect to lives with much lower risks of microvascular complications.