Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva 49202, Israel.
J Diabetes Res. 2018 Jul 9;2018:9572817. doi: 10.1155/2018/9572817. eCollection 2018.
The transition of emerging adults with type 1 diabetes (T1D) from pediatric diabetes clinics to adult clinics between 18 and 21 years of age could result in decreased clinic attendance and thus worsen glycemic control. Our institutional policy offering surveillance till age 30 enabled us to evaluate clinic attendance without the confounding effect of transition. Our aim was to determine the association between glycemic control (HbA1c) and attendance rate.
The medical records of 261 (54% males) young adult T1D patients (median age 22.9 years) were reviewed. Patients were stratified according to the attainment/nonattainment of glycemic targets (HbA1c ≤ 7% versus HbA1c > 7% (53 mmol/mol)). The attendance rate was calculated as the number of clinic visits/number of scheduled appointments.
Median annual number of scheduled visits was 3 (3, 4); attendance rate was 75% (53.6%, 100%). Seventy-four (28.4%) patients attained glycemic targets (median HbA1c 6.5% (48 mmol/mol) (6.3%, 6.8% (45.51 mmol/mol)); 187 (71.6%) patients had a median HbA1c of 7.8% (62 mmol/mol) (7.4%, 8.4% (57.68 mmol/mol)). The attainment of the treatment target was more prevalent in older patients ( = 0.006), in male patients ( = 0.007), and in patients with higher education ( = 0.017). Higher attendance rate ( (2.483), < 0.001) and male gender ( (0.746), = 0.015) were associated with better metabolic control.
In emerging adults with T1D during the ongoing stable phase of diabetes management, higher attendance rate, rather than absolute number of clinic visits, was associated with the attainment of glycemic targets.
18-21 岁期间，患有 1 型糖尿病（T1D）的青年患者从儿科糖尿病诊所过渡到成人诊所，可能会导致就诊次数减少，从而导致血糖控制恶化。我们机构的政策是提供至 30 岁的监测，这使我们能够在没有过渡混杂因素的情况下评估就诊情况。我们的目的是确定血糖控制（HbA1c）与就诊率之间的关系。
回顾了 261 名（54%为男性）年轻成年 T1D 患者（中位年龄 22.9 岁）的病历。根据是否达到/未达到血糖目标（HbA1c≤7%与 HbA1c>7%（53mmol/mol））对患者进行分层。就诊率计算为就诊次数/预约次数。
中位年预约就诊次数为 3（3，4）；就诊率为 75%（53.6%，100%）。74 名（28.4%）患者达到血糖目标（中位 HbA1c 为 6.5%（48mmol/mol）（6.3%，6.8%（45.51mmol/mol））；187 名（71.6%）患者的中位 HbA1c 为 7.8%（62mmol/mol）（7.4%，8.4%（57.68mmol/mol））。在年龄较大的患者（=0.006）、男性患者（=0.007）和接受更高教育的患者（=0.017）中，更常见达到治疗目标。更高的就诊率（ (2.483)， <0.001）和男性性别（ (0.746)，=0.015）与更好的代谢控制相关。
在 1 型糖尿病青年患者处于糖尿病管理的稳定阶段时，更高的就诊率（而非就诊次数绝对值）与血糖目标的实现相关。
