The transition to young adulthood in youth with type 1 diabetes on intensive treatment

被引:79
作者
Insabella, Glendessa
Grey, Margaret
Knafl, George
Tamborlane, William
机构
[1] Yale Univ, Sch Nursing, New Haven, CT 06517 USA
[2] Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR USA
[3] Yale Univ, Sch Med, Dept Pediat, New Haven, CT 06510 USA
关键词
metabolic control; quality of life; transition; type; 1; diabetes; young adulthood;
D O I
10.1111/j.1399-5448.2007.00266.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
yObjective: We sought to examine prospectively patterns of clinical and psychosocial outcomes during the transition from adolescence to young adulthood in a cohort initiating intensive therapy after the Diabetes; Control and Complications Trial. Research design and methods: We conducted a prospective, descriptive analysis of data from a randomized intervention study with 117 adolescents (45 males and 72 females, mean age at entry = 14.4 +/- 2.0 yr, mean diabetes duration at entry = 5.7 +/- 3.7 yr) recruited from a large pediatric diabetes clinic. Data were collected for each subject over periods of up to 5 yr at 6-month intervals using measures of depressive symptoms, quality of life, and metabolic control, with chart review for prevalence of diabetes complications. Results: Metabolic control worsens during adolescence but returns to early adolescent levels in young adulthood. The negative impact of diabetes on quality of life, disease-related worries, and life satisfaction did not change significantly with age. These results did not vary with treatment group or gender. Participants who showed high levels of depressive symptoms as adolescents were somewhat more likely to be depressed when older. Despite relatively long duration of diabetes, relatively few complications were observed in young adulthood. Conclusions: These data suggest that youth who begin intensive treatment as adolescents generally have good metabolic and psychosocial outcomes as young adults. However, those who have high levels of depressive symptoms in adolescence tend to continue to have such symptoms in early adulthood.
引用
收藏
页码:228 / 234
页数:7
相关论文
共 29 条
[1]  
*AM DIAB ASS, 2005, DIABETES CARE S1, V28, pS1
[2]   IMPAIRED INSULIN ACTION IN PUBERTY - A CONTRIBUTING FACTOR TO POOR GLYCEMIC CONTROL IN ADOLESCENTS WITH DIABETES [J].
AMIEL, SA ;
SHERWIN, RS ;
SIMONSON, DC ;
LAURITANO, AA ;
TAMBORLANE, WV .
NEW ENGLAND JOURNAL OF MEDICINE, 1986, 315 (04) :215-219
[3]   Diabetes self-care: Lessons from research on the family and broader contexts [J].
Barbara J. Anderson .
Current Diabetes Reports, 2003, 3 (2) :134-140
[4]  
[Anonymous], 1985, PSYCHOPHARMACOL BULL
[5]   Poor prognosis of young adults with type 1 diabetes - A longitudinal study [J].
Bryden, KS ;
Dunger, DB ;
Mayou, RA ;
Peveler, RC ;
Neil, HAW .
DIABETES CARE, 2003, 26 (04) :1052-1057
[6]   Clinical and psychological course of diabetes from adolescence to young adulthood - A longitudinal cohort study [J].
Bryden, KS ;
Peveler, RC ;
Stein, A ;
Neil, A ;
Mayou, RA ;
Dunger, DB .
DIABETES CARE, 2001, 24 (09) :1536-1540
[7]   Eating habits, body weight and insulin misuse - A longitudinal study of teenagers and young adults with type 1 diabetes [J].
Bryden, KS ;
Neil, A ;
Mayou, RA ;
Peveler, RC ;
Fairburn, CG ;
Dunger, DB .
DIABETES CARE, 1999, 22 (12) :1956-1960
[8]   CHRONIC DISEASE AND ITS IMPACT - THE ADOLESCENTS PERSPECTIVE [J].
CAPPELLI, M ;
MCGRATH, PJ ;
HEICK, CE ;
MACDONALD, NE ;
FELDMAN, W ;
ROWE, P .
JOURNAL OF ADOLESCENT HEALTH, 1989, 10 (04) :283-288
[9]  
Davidson M, 1997, J Soc Pediatr Nurs, V2, P65, DOI 10.1111/j.1744-6155.1997.tb00062.x