Clinical status and treatment adherence of young adults with type one diabetes mellitus following transition to adult health care

OBJECTIVE: This paper highlights the treatment factors of concern after the transition from an outpatient clinic for children and adolescents to an outpatient clinic for adults. MATERIAL AND METHODS: Participants were 56 individuals with diabetes type one in their twenties seeking treatment at the Diabetes clinic at Landspitali-University Hospital. In all, 72 outpatients met inclusion criteria and the response rate was 78%. RESULTS: On the average HbA1c measures were above the American Diabetes Association treatment target, which is HbA1c less than 7%. In the preceding twelve months only 28,6% participants attended at least four routine appointments. Half of the women and 30% of the men suffered from complications, retinopathy being most common. Quarter of the participants smoked, which is the same proportion as for all Icelanders aged 20-29 years old. The smokers had more symptoms of depression and anxiety. 19% of participants used psychotropic medication which is more than twice as high as in the normal population of Iceland. CONCLUSIONS: Special attention should be made to the fact that HbA1c measures were on the average above the treatment target and complications were common. Psychotropic medication usage was high which indicates that more cooperation between the Diabetes clinic and psychologists and/or psychiatrists is needed. New methods should be explored in reaching out to young people with diabetes.