Glycemic control over 3 years in a young adult clinic for patients with type 1 diabetes

Abstract

ObjectiveTo evaluate the effect of specialized young adult diabetes clinic (YAC) on glycemic control in a young adult patients with type 1 diabetes (DM1) transitioning from pediatric to adult diabetes care. Research design and methodsHbA1c was retrospectively analyzed through 3 years in 15–25 y/o DM1 patients entering a YAC, and compared to similar patients entering general endocrine clinics (GEC) in a university diabetes center. ResultsNinety-six patients were seen in the YAC, compared to 153 patients in the GEC. No difference in HbA1c was seen at entry (YAC 9.0±2.3% versus 8.8±2.3%). HbA1c did not change over time in either clinic (mean 3-year HbA1c 8.6±2.1% in YAC versus 8.4±2.3% in GEC). When the HbA1c values were divided into tertiles, no differences in distribution of baseline HbA1c were seen. Within the highest tertile, the YAC had a greater fall in HbA1c, compared to the GEC. Pump users from both clinics had HbA1c values 1% lower at each time point. ConclusionsYoung adults with DM1 continue to have difficulty achieving target HbA1c values. Earlier use of pump therapy and a specialized YAC for those with the worst glycemic control will benefit this population.