Young rural Australians with type 1 diabetes mellitus (T1DM) have limited access to adult diabetes health services and contact with specialist staff, and aren’t effectively transitioning from child to adult health services, according to an article published in the Medical Journal of Australia.
The article finds that diabetes the management of young Australians, and uptake of routine monitoring and preventative services, is poor in several Australian regions.
Dr Kate Steinbeck, Medical Foundation Chair in Adolescent Medicine, at the University of Sydney and co-authors at the University of Newcastle documented the diabetes health services use and diabetes management of young people with T1DM from the time of their first contact with adult services, and compared results for people using services in the capital city, a smaller city and a rural area of NSW, against clinical guideline targets.
The records of 239 young adults aged 18-28 years with T1DM from regional and urban areas were accessed for the study.
Dr Steinbeck said that, routine preventative service uptake during the first year of contact with adult services was significantly higher in urban areas.
“In the regional areas, routine review did not occur reliably, even annually, with marked attrition of patients from adult services after the first year of service,” Dr Steinbeck said.
“In regional areas, adolescents transfer from multidisciplinary ‘one stop shop’ paediatric outreach clinics to very differently configured adult diabetes services.”
“Improving self management is needed to prepare young people for these changes, as well as improvements in service coordination and appointment of case managers, to help them navigate adult care.”
“A combination of poor engagement and early loss of contact with adult services is resulting in poorer self-management and outcomes for young people with T1DM.”
“Specialist diabetes health care professionals are in short supply, and GPs need to be supported to develop T1DM expertise.”