Child to adult transition for patients with DM

January 01, 0001

Child to adult transition for patients with DM

These Canadian authors goals sought to characterize rates of diabetes mellitus (DM)-related hospitalizations and retinopathy screening before and after transition to adult care using a retrospective cohort study. They enrolled 1507 young adults with DM and followed them until 20 years of age.

They found: “DM-related hospitalization rates increased from 7.6 to 9.5 cases per 100 patient-years in the 2 years after transition to adult care. Previous DM-related hospitalizations, lower income, female gender, and living in areas with low physician supply were associated with higher admission rates. With controlling for all other factors, individuals who were transferred to a new allied health care team with no change in physician were 77% less likely (relative risk: 0.23) to be hospitalized after the transition than were those transferred to a new physician with either a new or no allied health care team. The rates of eye examinations were stable across the transition to adult care (72% vs 70%). Female patients, patients with higher income, and patients with previous eye care were more likely to have an eye care visit after transfer.”

The authors concluded: “During the transition to adult health care, there is increased risk of DM-related hospitalizations, although this may be attenuated in youths for whom there is physician continuity. Eye care visits were not related to transition; however, rates were below evidence-based guideline recommendations.”

This study supports the role of Family Physicians by indicating the importance of continuity of physician care in the pediatric to adult transition.

For the full abstract, click here.

Pediatrics 124(6): e1134-e1141, December 2009. © 2009 to the American Academy of Pediatrics
Transition to Adult Care for Youths With Diabetes Mellitus- Findings From a Universal Health Care System. Meranda Nakhla, Denis Daneman, Teresa To, Gilles Paradis, and Astrid Guttmann.

Category: HSR. Health Services Research, T. Endocrine/Metabolic/Nutritional. Keywords: diabetes, hospitalizations, ophthalmologic screening, pediatric, transition of care, retrospective cohort study
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 21 January 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.