Eroukhmanoff Juliette, Ballot Schmit Claire, Baron Sabine, Bahloul Amar, Beltrand Jacques, Salame Zeina, Borot Sophie, Dalla Vale Fabienne, Mosnier Pudar Helen, Nicolino Marc, Penfornis Alfred, Renard Eric
Department of Diabetology-Endocrinology, Hospital Center Sud Francilien (Centre Hospitalier Sud Francilien), Corbeil-Essonnes, France.
Paediatric Department, Jean Minjoz University Hospital, Besançon, France.
Diabetes Ther. 2024 Oct;15(10):2211-2222. doi: 10.1007/s13300-024-01630-6. Epub 2024 Aug 10.
The transition from paediatric to adult diabetes care (TPA) of children/adolescents with type 1 diabetes (T1D) represents a unique challenge and remains a critical phase in the T1D care pathway. This study aims to describe and understand the experience of the transition process from a participant's perspective in young adults who are living in France with T1D and to measure their satisfaction.
An online questionnaire was presented to people with T1D in France on a global online participant community platform. The questionnaire was developed by a scientific committee including paediatric and adult diabetologists and refined by a group of participants. Thematic qualitative analysis was performed on the responses.
A total of 104 respondents were included in the survey (mean age 24.4 years [95% CI 23.8-25.0]; 61.5% female). The mean age at the time of transition was 18.4 years (95% CI 17.8-18.9), and 56% of respondents had their first adult diabetology follow-up in the same institution. During TPA, of the 76 participants who experienced personal issues, 74% experienced at least one issue with their diabetes management in the months following the transition. In the following months, 61% experienced new or unexpected problems in monitoring their diabetes after transition and 44% reported unusual glycaemic imbalances, including hypoglycaemia (8%) and hyperglycaemia (9%) requiring hospitalisation. Presence of personal issues during TPA was significantly associated with occurrence of problems with diabetes management or glycaemic imbalance. Three factors identified for a successful transition were (i) early meeting with the 'adult' diabetes care team, (ii) letting the participants choose the right age to leave paediatric clinic and (iii) having good diabetes control at the beginning of the TPA process.
Most young adults with T1D report experiencing issues around TPA with significant consequences on their disease management. Hence, it is necessary to identify these issues to better support them and improve diabetes management during this phase.
1型糖尿病（T1D）儿童/青少年从儿科糖尿病护理过渡到成人糖尿病护理（TPA）是一项独特的挑战，并且仍然是T1D护理路径中的关键阶段。本研究旨在从参与者的角度描述和了解法国年轻成人T1D患者在过渡过程中的经历，并衡量他们的满意度。
在一个全球在线参与者社区平台上向法国的T1D患者发放了一份在线问卷。该问卷由一个包括儿科和成人糖尿病专家的科学委员会制定，并由一组参与者进行完善。对回复进行了主题定性分析。
共有104名受访者参与了调查（平均年龄24.4岁[95%CI 23.8 - 25.0]；61.5%为女性）。过渡时的平均年龄为18.4岁（95%CI 17.8 - 18.9），56%的受访者在同一机构进行了首次成人糖尿病随访。在TPA期间，76名经历个人问题的参与者中，74%在过渡后的几个月里在糖尿病管理方面至少遇到一个问题。在接下来的几个月里，61%的参与者在过渡后监测糖尿病时遇到新的或意外的问题，44%报告有异常的血糖失衡，包括需要住院治疗的低血糖（8%）和高血糖（9%）。TPA期间存在个人问题与糖尿病管理问题或血糖失衡的发生显著相关。确定的成功过渡的三个因素是：（i）尽早与“成人”糖尿病护理团队会面；（ii）让参与者选择离开儿科诊所的合适年龄；（iii）在TPA过程开始时血糖控制良好。
大多数患有T1D的年轻成人报告在TPA期间遇到问题，这对他们的疾病管理有重大影响。因此，有必要识别这些问题，以便在此阶段更好地支持他们并改善糖尿病管理。
