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Diabetes transition to adult care

Jeanne M Little, Janice A Odiaga, Carla Z Minutti
For adolescents with diabetes, ineffective health care transition to adult health services may result in suboptimal adherence to medical supervision, leading to poor glycemic control, increased diabetes complications, and hospitalization. Despite national recommendations, few youth receive the needed preparation to transition to adult health services. A data transition registry was created at a large Midwest urban academic medical center to identify patients 14 years and older with Type 1 diabetes. Thirty-nine patients with Type 1 diabetes were identified, and 33 were eligible to begin transition planning...
September 29, 2016: Journal of Pediatric Health Care
Christy Foster, Jayne Bellando, Yu-Chi Annie Wang
Type 1 diabetes is a chronic disease that can lead to severe complications if poorly controlled. Adolescents are particularly vulnerable to worsening diabetes control due to changes in physiology, family dynamics, and social interactions. Good diabetes control requires following a regimen of frequent blood glucose checks, accurate carbohydrate counts, and compliance with insulin administration. Patients who are challenged in controlling their diabetes do tend to respond to behavioral interventions; however, the effect of the intervention wanes over time...
September 1, 2016: Pediatric Annals
Shivani Agarwal, Katharine C Garvey, Jennifer K Raymond, Mark H Schutta
BACKGROUND: Healthcare transition from pediatric to adult care for young adults (YA) with type 1 diabetes (T1D) is associated with risk of adverse outcomes. Consensus recommendations exist from US professional societies on transition care for YA with T1D, but it is not known whether they have been widely adopted. We describe experiences, barriers, and provider characteristics associated with transition care in a national sample of pediatric endocrinologists. METHODS: US pediatric endocrinologists identified through the American Medical Association Physician Masterfile were sent an electronic survey...
August 31, 2016: Pediatric Diabetes
David M Levine, Michael J Healey, Adam Wright, David W Bates, Jeffrey A Linder, Lipika Samal
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) canceled Meaningful Use (MU), replacing it with Advancing Care Information, which preserves many MU elements. Therefore, transitioning from MU stage 1 to MU stage 2 has important implications for the new policy, yet the quality of care provided by physicians transitioning from MU1 to MU2 is unknown. METHODS: Retrospective longitudinal evaluation of the quality of care delivered by outpatient physicians at an academic medical center in the transition between MU1 and MU2...
August 26, 2016: Journal of the American Medical Informatics Association: JAMIA
Jane N T Sattoe, Mariëlle A C Peeters, Sander R Hilberink, Erwin Ista, AnneLoes van Staa
INTRODUCTION: To support young people in their transition to adulthood and transfer to adult care, a number of interventions have been developed. One particularly important intervention is the transition clinic (TC), where paediatric and adult providers collaborate. TCs are often advocated as best practices in transition care for young people with chronic conditions, but little is known about TC models and effects. The proposed study aims to gain insight into the added value of a TC compared with usual care (without a TC)...
2016: BMJ Open
Kris English, Emily Pajevic
In 2007, the World Health Organization published a set of International Classification of Functioning, Disability and Health (ICF) codes designed for children and youth (ICF-CY version). The ICF-CY considers typical developmental changes associated with childhood while describing health status and the effects of intervention. In this article we will describe how a specific intervention (transition planning for adolescents) can be documented with the ICF-CY. Transition planning in health care prepares adolescents and their families for the transfer from pediatric to adult health services and has been demonstrated to be an effective practice for adolescents with many types of chronic health conditions (e...
August 2016: Seminars in Hearing
Suzanne McLaughlin, Christopher Terry, Jodie Neukirch, Deborah Garneau, Deb Golding, Joanna Brown
The transitioning of youth from pediatric to adult care systems is often fraught with discontinuity, miscommunication and gaps in care. This is most significant for youth with special health care needs. A panel discussion on transitioning youth to adult care systems that was part of a learning collaborative held by The RI Care Transformation Collaborative (CTC) is presented here, illustrated by a pertinent case of a youth with type 1 diabetes. [Full article available at
2016: Rhode Island Medical Journal
Klodian Dhana, Jana Nano, Symen Ligthart, Anna Peeters, Albert Hofman, Wilma Nusselder, Abbas Dehghan, Oscar H Franco
BACKGROUND: Overweight and obesity are associated with increased risk of type 2 diabetes. Limited evidence exists regarding the effect of excess weight on years lived with and without diabetes. We aimed to determine the association of overweight and obesity with the number of years lived with and without diabetes in a middle-aged and elderly population. METHODS AND FINDINGS: The study included 6,499 individuals (3,656 women) aged 55 y and older from the population-based Rotterdam Study...
July 2016: PLoS Medicine
Longjian Liu, Xuan Yang, Yong Long, Arshpreet Kaur Mallhi, Kathan Mehta, Erol Veznedaroglu, Xiaoyan Yin
BACKGROUND AND PURPOSE: Little attention was paid to the transition of care for stroke that may partially explain the long-term trend of stroke rates. We aimed to test the trend of hospitalization attributable to stroke in US adults. METHODS: Data from National Hospital Discharge Surveys 1980-2010 in patients aged ≥18 (n = 6,527,304) were analyzed to examine the trend of patients with first-list diagnoses of stroke. Stroke comorbidities were classified in stroke patients with second- to seven-listed diagnoses of coronary heart disease, hypertension, diabetes, arrhythmias, or hyperlipidemia...
July 13, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Hood Thabit, Roman Hovorka
The artificial pancreas (closed-loop system) addresses the unmet clinical need for improved glucose control whilst reducing the burden of diabetes self-care in type 1 diabetes. Glucose-responsive insulin delivery above and below a preset insulin amount informed by sensor glucose readings differentiates closed-loop systems from conventional, threshold-suspend and predictive-suspend insulin pump therapy. Insulin requirements in type 1 diabetes can vary between one-third-threefold on a daily basis. Closed-loop systems accommodate these variations and mitigate the risk of hypoglycaemia associated with tight glucose control...
September 2016: Diabetologia
Antoine Rachas, Delphine Lefeuvre, Laurence Meyer, Albert Faye, Nizar Mahlaoui, Elise de La Rochebrochard, Josiane Warszawski, Pierre Durieux
CONTEXT: Appropriate outcomes are required to evaluate transition programs' ability to maintain care continuity during the transfer to adult care of youths with a chronic condition. OBJECTIVE: To identify the outcomes used to measure care continuity during transfer, and to analyze current evidence regarding the efficacy of transition programs. DATA SOURCES: PubMed (1948-2014), Web of Science (1945-2014), Embase (1947-2014), and the reference lists of the studies identified...
July 2016: Pediatrics
Sarah J Beal, Ilka K Riddle, Jessica C Kichler, Amie Duncan, Andrea Houchen, Lori Casnellie, Jason Woodward, Sarah D Corathers
OBJECTIVE: Identifying differences in transition readiness according to chronic condition is essential for understanding whether special emphasis within specific populations is warranted. Youth with chronic conditions (type 1 diabetes, Turner syndrome, spina bifida, autism spectrum disorder [ASD]) representing various types of impairments were compared with youth without chronic conditions. It was hypothesized that differences would be observed according to condition type, with youth with cognitive/behavioral conditions showing less readiness than youth with other conditions and youth without chronic conditions showing the highest levels of transition readiness...
September 2016: Academic Pediatrics
Sheila M Quinn, Jodie M Ambrosino, Elizabeth A Doyle, K Weyman, William V Tamborlane, Ania M Jastreboff
OBJECTIVE: Screening for depression, diabetes distress, and disordered eating in youth with type 1 diabetes (T1D) is recommended, as these comorbidities contribute to poor glycemic control. No consensus exists on which measures are optimal, and most previous studies have used nondisease-specific measures. We examined the utility of screening for these disorders using two disease-specific and one general measure at the time of transition from pediatric to adult care. METHODS: Forty-three young adults from a T1D transition clinic completed the Patient Health Questionnaire, the Diabetes Distress Scale, and the Diabetes Eating Problem Survey-Revised...
September 2016: Endocrine Practice
Maria I Creatore, Richard H Glazier, Rahim Moineddin, Ghazal S Fazli, Ashley Johns, Peter Gozdyra, Flora I Matheson, Vered Kaufman-Shriqui, Laura C Rosella, Doug G Manuel, Gillian L Booth
IMPORTANCE: Rates of obesity and diabetes have increased substantially in recent decades; however, the potential role of the built environment in mitigating these trends is unclear. OBJECTIVE: To examine whether walkable urban neighborhoods are associated with a slower increase in overweight, obesity, and diabetes than less walkable ones. DESIGN, SETTING, AND PARTICIPANTS: Time-series analysis (2001-2012) using annual provincial health care (N ≈ 3 million per year) and biennial Canadian Community Health Survey (N ≈ 5500 per cycle) data for adults (30-64 years) living in Southern Ontario cities...
May 24, 2016: JAMA: the Journal of the American Medical Association
Huaqiong Zhou, Pamela Roberts, Satvinder Dhaliwal, Phillip Della
AIMS AND OBJECTIVES: This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. BACKGROUND: Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development...
May 5, 2016: Journal of Clinical Nursing
Fiona Campbell, Katie Biggs, Susie K Aldiss, Philip M O'Neill, Mark Clowes, Janet McDonagh, Alison While, Faith Gibson
BACKGROUND: There is evidence that the process of transition from paediatric (child) to adult health services is often associated with deterioration in the health of adolescents with chronic conditions.Transitional care is the term used to describe services that seek to bridge this care gap. It has been defined as 'the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centred to adult-oriented health care systems'. In order to develop appropriate services for adolescents, evidence of what works and what factors act as barriers and facilitators of effective interventions is needed...
2016: Cochrane Database of Systematic Reviews
Nguyen Thy Khue
BACKGROUND: The prevalence for diabetes, prediabetes, and gestational diabetes in Vietnam are low relative to other parts of the world, but they are increasing at alarming rates. These changes have occurred in the setting of economic and cultural transitions. OBJECTIVES: The aim of this study was to provide relevant information depicting the diabetes burden in Vietnam. METHODS: Literature was reviewed using PubMed and local Vietnamese sources, including papers published in the Vietnamese language...
November 2015: Annals of Global Health
Susan Brumm, Kathleen Theisen, Mercedes Falciglia
PURPOSE: The purpose of the study was to evaluate a diabetes transition care program in a population of veterans with diabetes by calculating 30-day readmission rates and assessing glycemic control. METHODS: Hospitalized patients with poorly controlled diabetes were identified to participate in the diabetes transition care program. The program included follow-up through a postdischarge telephone call by the diabetes educator, with an opportunity for a face-to-face clinic visit...
June 2016: Diabetes Educator
Bénédicte Stengel, Christian Combe, Christian Jacquelinet, Serge Briançon, Denis Fouque, Maurice Laville, Luc Frimat, Christophe Pascal, Yves-Édouard Herpe, Pascal Morel, Jean-François Deleuze, Joost P Schanstra, Ron L Pisoni, Bruce M Robinson, Ziad A Massy
BACKGROUND: Preserving kidney function and improving the transition from chronic kidney disease to end stage is a research and healthcare challenge. The national Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort was established to identify the determinants, biomarkers and practice patterns associated with chronic kidney disease outcomes. METHODS: The study will include more than 3000 adult patients with moderate to advanced chronic kidney disease from a representative sample of 40 nephrology clinics with respect to regions and legal status, public or private...
April 2016: Néphrologie & Thérapeutique
Yoshiko Onda, Rimei Nishimura, Aya Morimoto, Hironari Sano, Kazunori Utsunomiya, Naoko Tajima
OBJECTIVE: To follow up Japanese patients with type 1 diabetes for a maximum of 40 years to examine when they transitioned from pediatric care to adult care and to explore whether the attending physician, i.e., pediatrician or internist, was associated with prognosis. METHODS: Participants consisted of 1,299 patients who had been diagnosed as having type 1 diabetes at less than 15 years old between 1965 and 1979 identified through two nationwide surveys. Patients were classified as having received either pediatric care or adult care at the age of 15 and 30, and were compared for differences in mortality associated with the attending physician...
2016: PloS One
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