Department of Pediatrics, Romagna Local Health Authority, Santa Maria delle Croci Hospital, Viale Randi 5, AUSL della Romagna, Ravenna, Italy.
Diabetes Clinic, Romagna Local Health Authority, Santa Maria delle Croci Hospital, Ravenna, Italy.
Acta Diabetol. 2024 Aug;61(8):1069-1076. doi: 10.1007/s00592-024-02268-3. Epub 2024 May 3.
The present study assessed the transitioning process of young adults with type 1 diabetes mellitus (T1D) in Italy.
We asked Pediatric Diabetes Centers (PDC) and Adult Diabetes Centers (CAD) to fill in a web-based survey on the current state of services, the number of transitioning adolescents with T1D within the last year, observations on limitations, and future directions.
93 centers (46 PDCs, 47 CADs) joined the study. The total number of subjects with T1D being followed by a PDC was 16,261 (13,779 minors and 2483 young adults), while CADs had 25,500 patients. The survey showed an uneven situation. Only some services had a dedicated diabetes team (78% of PDCs, 64% of CADs). 72% of PDCs and 58% of CADs reported a protocol dedicated to transition. The median age for transition was 19 (range 16-25 years); the time required for preparing transition, indicated by both PDCs and CADs, was 5.5 months. A high percentage of CADs (80%) confirmed receiving sufficient clinical information, mainly through paper or computerized reports. The transition process is hampered by a lack of resources, logistical facilities, and communication between services. While some services have a protocol, monitoring of results is only carried out in a few cases. Most specialists expressed the need to enhance integration and continuity of treatment.
The current situation could be improved. Applying standard guidelines, taking into consideration both clinicians' and patients' necessities, would lead to a more successful transition process.
本研究评估了意大利青少年 1 型糖尿病(T1D)患者的过渡进程。
我们要求儿科糖尿病中心(PDC)和成人糖尿病中心(CAD)填写一份关于服务现状、过去一年中接受 T1D 过渡治疗的青少年人数、观察到的限制因素以及未来方向的网络调查。
93 个中心(46 个 PDC,47 个 CAD)参与了研究。由 PDC 随访的 T1D 患者总数为 16261 人(13779 名未成年人和 2483 名年轻人),而 CAD 有 25500 名患者。调查显示情况参差不齐。只有部分服务有专门的糖尿病团队(78%的 PDC,64%的 CAD)。72%的 PDC 和 58%的 CAD 报告有专门的过渡方案。过渡的中位年龄为 19 岁(范围 16-25 岁);PDC 和 CAD 都表示需要 5.5 个月的时间来准备过渡。大多数 CAD(80%)确认收到了足够的临床信息,主要通过纸质或计算机报告。过渡过程受到资源、后勤设施和服务间沟通的限制。虽然一些服务有方案,但只有少数情况下会对结果进行监测。大多数专家表示需要加强治疗的整合和连续性。
目前的情况可以得到改善。应用标准指南,同时考虑临床医生和患者的需求,将导致更成功的过渡过程。