青少年期糖尿病向成人护理的过渡：与1型糖尿病相比，青少年期2型糖尿病社会生态因素的范围综述

Transitioning to adult care in youth-onset diabetes: a scoping review of socio-ecological factors in youth-onset type 2 diabetes compared to type 1 diabetes.

作者信息

Ude Assumpta O, Dixon Sydney A, Glaros Sophia B, Arboine Sue-Ann, Terry Nancy L, Cabeza De Baca Tomás, Chung Stephanie T

机构信息

Clinical Center Nursing Department, National Institutes of Health, Bethesda, MD, USA.

Section on Pediatric Diabetes, Obesity, and Metabolism, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Drive, BLD-10 CRC, RM 5-5942, Bethesda, MD, 20814, USA.

出版信息

BMC Public Health. 2025 May 15;25(1):1784. doi: 10.1186/s12889-025-22956-1.

DOI:10.1186/s12889-025-22956-1

PMID:40375107

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12080029/

Abstract

BACKGROUND

Multiple socio-cultural and personal factors influence the transition from pediatric to adult-centered diabetes care in youth-onset type 1 diabetes (Y-T1D), but few data exist in youth-onset type 2 diabetes (Y-T2D). We determined the scope of the literature on socio-ecological factors associated with transitioning to adult care in Y-T2D compared with Y- T1D to identify facilitators, barriers, and knowledge gaps in Y-T2D.

METHOD

We conducted a global scoping review using the Systematic Reviews and Meta-Analyses for scoping reviews (PRISMA-ScR) guidelines. Eligible articles were peer-reviewed experimental and quasi-experimental articles published between January 1990 and September 2022, with no language restrictions.

RESULTS

In 104 articles that reported on transitioning to adult care, 88% were in Y-T1D, 6% compared Y-T1D and Y-T2D, 2% reported in Y-T2D only, and 4% reported on youth-onset diabetes diagnosis. The proportion of articles that reported on socio-ecological domains were similar in Y-T1D compared to articles that included Y-T2D. Identified challenges associated with the transitioning period in Y-T2D were societal (structural bias, poverty, inadequate social support), health cultural (limited access to adult health-care providers), psychological (feelings of anxiety and fear of transition), and behavioral (difficulty with medication adherence). The transition period was associated with worsening glycemic control in both groups.

CONCLUSIONS

Y-T2D face multiple challenges across socio-ecological domains during the transition to adult-centered diabetes care. However, only 8% of studies on transitioning factors included Y-T2D and additional research is needed to develop dynamic and robust transition programs in Y-T2D.

SCOPING REVIEW REGISTRATION

Protocol was registered with Open Science Framework, April 4, 2022. https://osf.io/k2pwc .

摘要

背景

多种社会文化和个人因素影响着青少年期1型糖尿病（Y-T1D）从儿科向以成人为中心的糖尿病护理的过渡，但青少年期2型糖尿病（Y-T2D）的相关数据较少。我们确定了与Y-T2D相比，Y-T1D中与向成人护理过渡相关的社会生态因素的文献范围，以识别Y-T2D中的促进因素、障碍和知识差距。

方法

我们使用系统评价和元分析的范围综述（PRISMA-ScR）指南进行了一项全球范围综述。符合条件的文章为1990年l月至2022年9月发表的经同行评审的实验性和准实验性文章，无语言限制。

结果

在104篇报道向成人护理过渡的文章中，88%是关于Y-T1D的，6%比较了Y-T1D和Y-T2D，2%仅报道了Y-T2D，4%报道了青少年期糖尿病诊断。与包含Y-T2D的文章相比，Y-T1D中报道社会生态领域的文章比例相似。在Y-T2D中，确定的与过渡时期相关的挑战包括社会方面（结构偏见、贫困、社会支持不足）、健康文化方面（获得成人医疗服务提供者的机会有限）、心理方面（焦虑情绪和对过渡的恐惧）以及行为方面（药物依从性困难）。两组在过渡时期血糖控制均有所恶化。