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Article

Eight-Year Retrospective Study of Young Adults in a Diabetes Transition Clinic

1
Diabetes, Obesity and Metabolism Translational Research Unit, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
2
Translational Health Research Unit (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
3
Waikato Hospital, Hamilton 3240, New Zealand
4
Macarthur Diabetes Endocrinology and Metabolism Service, Campbelltown Hospital, Campbelltown, NSW 2560, Australia
*
Author to whom correspondence should be addressed.
Academic Editors: Ryan D. Burns and Wonwoo Byun
Int. J. Environ. Res. Public Health 2021, 18(23), 12667; https://doi.org/10.3390/ijerph182312667
Received: 10 November 2021 / Revised: 25 November 2021 / Accepted: 28 November 2021 / Published: 1 December 2021
The transition of people from paediatric to adult diabetes services is associated with worsening glycaemia and increased diabetes-related hospitalisation. This study compared the clinical characteristics of those with and without mental health conditions among attenders at a diabetes young adult clinic diabetes before and after changes in service delivery. Retrospective audit of 200 people with diabetes attending a Sydney public hospital over eight years corresponding to the period before (2012–2016) and after (2017–2018) restructuring of a clinic for young adults aged 16–25 years. Characteristics of those with and without mental health conditions (depression, anxiety, diabetes related distress, eating disorders), were compared. Among clinic attenders (type 1 diabetes n = 184, 83.2%), 40.5% (n = 89) had a mental health condition particularly, depression (n = 57, 64%), which was higher among Indigenous than non-Indigenous people (5.6% vs. 0.8%, p = 0.031) but similar between diabetes type. Over eight years, those with, compared with those without a mental health condition had higher haemoglobin A1c (HbA1c) at the last visit (9.4% (79 mmol/mol) vs. 8.7% (71 mmol/mol), p = 0.027), the proportion with diabetic ketoacidosis (DKA 60.7% vs. 42.7%, p = 0.009), smoking (38.4 vs. 13.6%, p = 0.009), retinopathy (9.0 vs. 2.3%, p = 0.025), multiple DKAs (28.4 vs. 16.0%, p = 0.031) were significantly higher. Having a mental health condition was associated with 2.02 (95% confidence intervals 1.1–3.7) fold increased risk of HbA1c ≥9.0% (75 mmol/mol). Changes to the clinic were not associated with improvements in mental health condition (39.0% vs. 32.4%, p = 0.096). In conclusion, we found that mental health conditions, particularly depression, are common in this population and are associated with diabetes complications. Diabetes type and clinic changes did not affect the reported mental health conditions. Additional strategies including having an in-house psychologist are required to reduce complication risks among those with mental health conditions. View Full-Text
Keywords: diabetic ketoacidosis; mental health; type 1 diabetes; transition; glycaemia diabetic ketoacidosis; mental health; type 1 diabetes; transition; glycaemia
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MDPI and ACS Style

Sritharan, A.; Osuagwu, U.L.; Ratnaweera, M.; Simmons, D. Eight-Year Retrospective Study of Young Adults in a Diabetes Transition Clinic. Int. J. Environ. Res. Public Health 2021, 18, 12667. https://doi.org/10.3390/ijerph182312667

AMA Style

Sritharan A, Osuagwu UL, Ratnaweera M, Simmons D. Eight-Year Retrospective Study of Young Adults in a Diabetes Transition Clinic. International Journal of Environmental Research and Public Health. 2021; 18(23):12667. https://doi.org/10.3390/ijerph182312667

Chicago/Turabian Style

Sritharan, Aarooran, Uchechukwu L. Osuagwu, Manjula Ratnaweera, and David Simmons. 2021. "Eight-Year Retrospective Study of Young Adults in a Diabetes Transition Clinic" International Journal of Environmental Research and Public Health 18, no. 23: 12667. https://doi.org/10.3390/ijerph182312667

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