Type 1 Diabetes Mellitus and Transfer from Pediatric to Adult Care: A Single-Center Experience

Objective: Type 1 diabetes mellitus (T1DM) requires lifelong follow-up, and the transition from pediatric to adult care may influence clinical outcomes. To evaluate sociodemographic, clinical, and laboratory characteristics associated with the transition process in patients with T1DM and to compare two different transition models. Methods: Patients with T1DM transferred to an adult outpatient clinic between 2001 and 2022 were retrospectively assessed. Demographic data, metabolic parameters, complications, and treatment modalities before and after transition were assessed. Transition was performed either as a single-session model (Model 1) or as a gradual process over 4-6 months (Model 2). Results: A total of 64 patients transitioned over the 21 year study period. The annual number of follow-up visits was significantly lower in adult care (3.0±0.9 vs. 2.1±1.8 visits/year; p=0.009). HbA1c levels were also lower in adulthood (8.9% vs. 8.3%; p=0.007). Total insulin dose was lower (0.95 vs. 0.75 IU/kg/day; p=0.009), whereas the basal insulin ratio was higher (43.1% vs. 52.8%; p<0.0001). Although mean body mass index slightly decreased, obesity prevalence increased. No significant differences were observed between the two transition models in terms of glycemic outcomes, insulin requirements, or complication rates. Conclusion: A structured transition process was associated with improved glycemic control and treatment adaptation in T1DM, regardless of whether it is implemented as a single-session or gradual model. The absence of major differences between models may support the importance of individualized, patient-centered transition strategies.