814-P: Clinical Factors Impacting Glycemic Control in Young Adults with Type 1 Diabetes at Transition to Adult Clinical Care

Abstract

Young adults (YA) with type 1 diabetes (T1D) transfer from pediatric to adult diabetes care during a time when many of them experience suboptimal glycemic control. To determine the factors impacting glycemic control in YA transitioning to adult care, we conducted a retrospective study of YA (age 17-30 years) with T1D establishing care at an adult tertiary diabetes-only clinic. Demographic, clinical characteristics, A1c at first visit, use of insulin pump or continuous glucose monitor (CGM), referral center, and insurance information were collected from the electronic medical record. Among 329 YA with T1D (55% female, 75% white, 40% on CGM, 55% on insulin pump), average age of transition was 23±3 years and mean A1c at first visit was 8.5±1.6%. We divided YA by A1c at first visit as ≤7.5% (n=96) and A1c≥8.5% (n=130). Patients with better glycemic control (A1c < 7.5% at first visit) were older and had more private insurance. Patients with better glycemic control also used more diabetes technology (59% vs. 43% on pump, 51% vs. 35% on CGM). In our cohort, older age at transfer, use of diabetes technology, referral center and private insurance status were associated with better glycemic control at first visit in adult care. These factors may be important for adult clinicians to consider when assessing YA with T1D at their first visit to develop a tailored diabetes self-management plan.View largeDownload slideView largeDownload slide DisclosureK. Flint: None. M. Bennetti: None. A. Atakov-castillo: None. E. Toschi: Consultant; Self; Medtronic.FundingSteven M. and Joyce E. Tadler Charitable Trust