Adolescents and young adults (AYA) with DM have increased risk of poor outcomes. The DTP was created to equip AYA with knowledge, support, and skills to foster successful lifelong DM self-management. This 1-year (4 visits) program pairs clinical care with peer-group discussions led by a multidisciplinary team focused on informed decision making of issues relevant to AYA with DM. The purpose of this study was to characterize the population referred to DTP and evaluate concerns, program adherence and outcomes. Medical records were reviewed and surveys administered. To date 153 AYA were referred (51% females, 99% T1DM, age at 1st visit 18.8±1.4 yrs, age at onset 9.7±4.7 yrs, HbA1c 9±2%). In ranking concerns of 5 complications (retinopathy, neuropathy, reproductive health complications, nephropathy and hypertension) at the 1st DTP visit, 60% of males and 57% of females who completed the survey rated retinopathy as their number 1 or 2 concern. Reproductive health and hypertension were listed as their least concern by 43% of males and 42% of females respectively. In terms of program adherence, the majority (60%, n=92) completed DTP on schedule (1 year). Of these, 42% transferred to adult care, 52% continued care at the institution and 6% were lost to follow up. Of those who did not complete DTP over 1 year (40%), 25% transferred to adult care before DTP completion, 60% are completing DTP in more than 1 year, and 15% were lost to follow up. Those who transferred to adult care (irrespective of program completion time), versus those who did not, had lower HbA1c at all DTP visits (e.g., 1st visit: 8.1 ± 1.4% vs. 9.4 ± 1.7%, p=0.01). In terms of outcomes for those that completed the program, no differences were found in HbA1c from the 1st to 4th visit.
In conclusion, AYA referred to DTP appear to be a high-risk population based on their HbA1c and suboptimal program adherence. This highlights the need for methods (e.g., telehealth) to continue to engage this population and ongoing self-management support.
I. Libman: Consultant; Self; Novo Nordisk A/S. J.T. Krall: Research Support; Self; Becton, Dickinson and Company. A.F. Fischl: None. J. Finney: None. A.M. Diaz: None. L.M. Siminerio: Research Support; Self; Becton, Dickinson and Company. D. Charron-Prochownik: None. D.J. Becker: None.
David Paul Diabetes Transition Care Research Initiative Fund