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Implementation of effective transition from pediatric to adult diabetes care: epidemiological and clinical characteristics—a pioneering experience in North Africa

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Abstract

Aims

Type 1 diabetes is increasing in children leading more T1D young adults to adult healthcare settings. This change is experienced as a tear and results in a disengagement from specialist services. This study reports on an implementation of an effective and pioneering program of transition in North Africa.

Methods

A total of 65 teenagers with T1D were recruited for a structured program of transition. They attend transitional meetings involving both pediatric and adult team and were, when ready, welcomed in specialized consultations for adolescents with a special « passport ». Here we study their characteristics before and after structured transition and the benefit of this program.

Results

9 transition meetings took place (September 2012–December 2017). Mean age was 16.5 years. Mean age at onset of T1D was 7.5 years with average pediatric follow-up of 9 years.72% of young adults felt satisfied. After the transition meeting, 74% of patients wished to join directly adult unit. They were followed there for 28.4 ± 16.2 months. The glycaemic control improved significantly with a decrease in HbA1C of 0.93 ± 1.69% the first year of follow-up and the number of young adults achieving a HbA1C < 7.5% increased by 8%.

Conclusion

This program was beneficial for 75% of patients who demonstrated an improvement in their metabolic control the year following transition to adult care service. To our knowledge, this study is the first one in North Africa to report on the outcome of a structured transition program from pediatric to adult diabetes care.

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Authors and Affiliations

  1. Faculté de Médecine de Tunis, Université de Tunis El Manar, 1007, Tunis, Tunisia

    Leïla Essaddam, Wafa Kallali, Manel Jemel, Hager Kandara, Inès Kammoun, Mohamed Hsairi, Leïla Ben Salem & Saayda Ben Becher

  2. Children Hospital Béchir Hamza de Tunis, Jebbari, 1007, Tunis, Tunisia

    Leïla Essaddam, Wafa Kallali & Saayda Ben Becher

  3. Unit of Endocrinology, Diabetology and Metabolic diseases, Institut National de Nutrition de Tunis, 1007, Tunis, Tunisia

    Manel Jemel, Hager Kandara, Inès Kammoun & Leïla Ben Salem

  4. Department of Epidemiology, Salah Azaiez Institute of Tunis, 1007, Tunis, Tunisia

    Mohamed Hsairi

  5. Tunis, Tunisia

    Leïla Essaddam

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  1. Leïla Essaddam
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  2. Wafa Kallali
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  3. Manel Jemel
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Correspondence to Leïla Essaddam.

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All the authors report no conflicts of interest in this work.

Statement of Human and Animal Rights

Our study have been reviewed by the hospital's ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki.

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All the persons cited gave their consent prior to their inclusion in the study. Details that might disclose identity of the subjects under study have been omitted.

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Essaddam, L., Kallali, W., Jemel, M. et al. Implementation of effective transition from pediatric to adult diabetes care: epidemiological and clinical characteristics—a pioneering experience in North Africa. Acta Diabetol 55, 1163–1169 (2018). https://doi.org/10.1007/s00592-018-1196-x

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  • DOI: https://doi.org/10.1007/s00592-018-1196-x

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