Lotstein and colleagues from the SEARCH for Diabetes in Youth Survey writing in the April 2013 edition of Pediatrics describe the sociodemographic and clinical correlates of poor glycemic control associated with the transfer of care from pediatric to adult diabetes providers among a cohort of youth with type 1 diabetes diagnosed in adolescence. The estimated median age of transition of care was 20.1 years (95% confidence interval 19.8–20.4). Older age, lower baseline glycosylated hemoglobin, and less parental education were independently associated with increased odds of transition. The odds of poor glycemic control at follow-up were 2.5 times higher for participants who transitioned to adult care compared with those who remained in pediatric care. The authors conclude "that transferring from pediatric to adult care, experienced by more than half the sample, was associated with an increased risk of poor glycemic control at follow-up. These findings suggest that young adults need additional support when moving to adult care."
PEDIATRICS Vol. 131 No. 4 April 1, 2013 pp. e1062 -e1070 (doi: 10.1542/peds.2012-1450)