[Experiences of patients and operators involved in the transition process from pediatric services to adult centers for young people with type 1 diabetes in Italy: the TransiDEA study (2nd phase)].

Abstract

Introduction: Type 1 diabetes mellitus (T1D) is a common chronic condition in children and adolescents, with increasing incidence. Adequate management is crucial for glycemic control and the prevention of complications. The transition from pediatric care centers to adult care centers is a critical phase, and its effectiveness varies among different countries and even within different areas of the same country.

Materials and methods: In this qualitative study conducted in 2023, at least 30 patients with T1D who had undergone the transition between 2017 and 2022 were invited to participate by completing an online semi-structured questionnaire regarding their transition experiences. Additional questionnaires were administered to healthcare professionals to gather information on organizational barriers and patient expectations.

Results: The survey conducted on 52 young adults with T1D from 5 Italian diabetes centers revealed that the transition to adult care typically occurs at an average age of 19.6 years. At the time of the survey, 73% of participants had not experienced acute complications, and 55.7% had optimal metabolic control prior to the transition. However, many patients encountered issues in the operational management of the transition, with about 40% describing the process as difficult, highlighting in some cases a feeling of "abandonment" and a desire for greater support and communication between pediatric and adult services. The majority of respondents reported an increase in autonomy in managing their diabetes.

Discussion and conclusions: Although the transition process for patients with T1D is structured, the study reveals some gaps in communication and support between pediatric and adult care centers. A well-coordinated pathway is essential, considering the individual needs of patients and strengthening collaboration between care teams.