Starship Children's Health, Paediatric Diabetes and Endocrinology Service, Auckland District Health Board, Auckland, New Zealand.
Starship Children's Health Children's Research Centre, Auckland District Health Board, Auckland, New Zealand.
Diabet Med. 2023 Mar;40(3):e15011. doi: 10.1111/dme.15011. Epub 2022 Nov 25.
To assess participation with a structured transition programme for adolescents with diabetes.
Data from a regional cohort aged less than 16 years of age with type 1 (T1) and type 2 diabetes (T2D) in Auckland, New Zealand (2006-2016). Participation was defined as opting into a structured transition programme.
Five hundrend and twelve adolescents who were to be transferred to adult care (476 type 1 (T1D) and 36 type 2 (T2D)), overall participation rate of 83%, 86% (408/476) with T1D compared to 47% (17/36) with T2D. Within the cohort of T1D, participation rates for Māori and Pacific were lower (74% and 77%, respectively) than New Zealand Europeans (88%, p = 0.020 and p = 0.039, respectively). Lower socio-economic status was associated with reduced participation (77%) compared to higher socio-economic status (90%, p = 0.002). Of the 476 T1D who participated, 408 (96%) subsequently attended at least one adult service clinic ("capture"). 42% attended an adult clinic within the planned 3 months, 87% at 6 months and retention in adult clinics over 5 years of follow-up was 78%. By contrast, the 68 young people with T1D who did not participate in the structured transition had a capture rate of 78% (p < 0.001) and retention of 63% (p = 0.036).
In adolescents with diabetes, a formal transition from a paediatric service was associated with high rates of adult capture and subsequent retention in adult care over a 5-year follow-up period. Low socio-economic status, Māori or Pacific ethnicity and T2D were associated with reduced participation in the structured transition programme.
评估参与青少年糖尿病结构化过渡计划的情况。
数据来自新西兰奥克兰的一个年龄小于 16 岁的 1 型（T1）和 2 型糖尿病（T2D）的区域队列（2006-2016 年）。参与定义为选择参加结构化过渡计划。
512 名青少年将转至成人护理（476 名 1 型（T1D）和 36 名 2 型（T2D）），总体参与率为 83%，T1D 为 86%（408/476），T2D 为 47%（17/36）。在 T1D 队列中，毛利人和太平洋岛民的参与率（分别为 74%和 77%）低于新西兰欧洲人（88%，p=0.020 和 p=0.039）。较低的社会经济地位与参与率降低（77%）相关，而较高的社会经济地位（90%）则相反（p=0.002）。在 476 名参与 T1D 的患者中，有 408 名（96%）随后至少参加了一次成人服务诊所（“捕获”）。42%在计划的 3 个月内参加了成人诊所，87%在 6 个月内参加，在 5 年的随访中，成人诊所的保留率为 78%。相比之下，68 名未参与结构化过渡的 T1D 年轻人的捕获率为 78%（p<0.001），保留率为 63%（p=0.036）。
在患有糖尿病的青少年中，从儿科服务到成人服务的正式过渡与成人就诊的高捕获率以及随后在 5 年随访期间在成人护理中的保留率相关。社会经济地位低、毛利人或太平洋岛民以及 T2D 与结构化过渡计划参与率降低相关。
