Background: Adolescents with type 1 diabetes (T1DM) often experience difficulty with transition from the paediatric to adult medical systems. Only few adolescent and young adults achieve goal haemoglobin A1c (HbA1c) targets. This transition process is difficult because of gaps in care and a lack of support provided in paediatric and adult setting. Transition care programs are recommended for this population to improve the diabetes outcomes, however there is limited evidence to determine whether such programs improve the diabetes outcomes. Aim: The purpose of this systematic review was to assess the effectiveness of transition care programs among adolescents with T1DM in improving glycaemic control. Methods: A systematic search was performed in the following databases: MEDLINE, EMBASE, and CINAHL. This systematic review was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) in terms of the quality of overall body of the evidence. Results: Transition care programs have statistically significant benefits on glycaemic control (p<0.01). Median difference of HbA1c (%) at follow up (after 1 year) was 1.2% in baseline HbA1c in favour of intervention group (transition care programs) (1.2%; 95 CI 0.4 - 1.9, p=0.01). The results show no clinical and statistical significance as there are no differences between two groups after three years. Conclusion: This review highlighted the importance of improving glycaemic control for adolescents with T1DM, which can benefit from additional support throughout transition. The results of this review might provide a key to future studies which rigorously evaluates the effect on HbA1c of effective transfer.
Anahtar Kelimeler: Transition care, type 1 diabetes, glycaemic control, HbA1c
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