Objectives: Transition age patients with T1D age 17 to 25 are at high risk of acute and chronic complications and poor glycemic control. Surveys of youth with T1D transitioning to adult care indicate they desire a formal transition process, orientation and introduction to an adult provider team. To address the needs of young adults with T1D, the YADC was created at the Harold Schnitzer Diabetes Health Center (HSDHC).
Methods: The YADC is a comprehensive half day clinic which includes group orientation with peers, behavioral health screening, diabetes education assessment and a medical provider visit. Youth referred for an appointment are given the option to schedule into the YADC. The YADC is part of the larger program Movin’ Up Movin’ On for transition age youth with T1D at the HSDHC.
Results: Thirty-four of 129 referred patients attended the YADC between November 2017 and December 2018. Half transferred care internally from pediatric to adult providers. Patients were predominantly from an urban area. Thirty eight percent had state medical insurance; 62% had commercial insurance. Mean a1c was 9.1. Five of 22 patients with available microalbumin levels screened positive for microalbuminuria. No patients reported retinopathy. Seventeen of 34 patients experienced inpatient admission or an ED visit between 2016 and 2018. Six patients had DKA in the year prior to their clinic visit. Greater than half the patients (20 of 34) had history of depression, anxiety or substance abuse listed in their medical record.
Conclusions: Transition of pediatric to adult care is associated with high risk for acute and chronic complications. This data illustrates the high-risk nature of the YADC attendees and highlights in particular the predominance of behavioral health challenges in this group.
F. Joarder: None. H. Nagra: None. L. Rocha: None. L. Andreas: None. I. Guttmann-Bauman: None. A.J. Ahmann: Advisory Panel; Self; Eli Lilly and Company, MannKind Corporation, Novo Nordisk Inc., Sanofi-Aventis. Consultant; Self; Dexcom, Inc. Research Support; Self; Dexcom, Inc., Medtronic.