Beim Transfer in die Erwachsenenversorgung verlieren 40 % der Jugendlichen mit einem
Typ-1-Diabetes den Kontakt zur Spezialmedizin, mit einem deutlich ansteigenden Risiko
für eine schlechtere glykämische Kontrolle und Folgeerkrankungen. Transitionsprogramme
sind nicht flächendeckend effektiv, und der zunehmende Einsatz moderner Technologien
in der Kinderdiabetologie erschwert den Übergang, wie dieser Beitrag aufzeigt.
Abstract
Approximately 40 % of adolescents with type 1 diabetes lose contact with specialty
care at transfer to adult care, with a marked increase in risk for poor outcomes.
Adolescents showed a 2,5-fold increased risk of an HbA1c level > 9 % after transfer, compared with adolescents who remained in pediatric care.
While the use of modern technologies is rapidly increasing in pediatric diabetology,
fewer resources are available to address the rapidly changing digital transformation
of type 1 diabetes therapy in adult diabetology, not least because of the large number
of patients with type 2 diabetes who require care. Therefore, in the transition from
children with type 1 diabetes to adult medicine, disparities in resource provision
for training and interpretation of new diabetes technologies now add to the problems
that have been known for many years. One possible solution would be the creation of
regional treatment centers with pediatric and internal medicine care for people with
intensive diabetes therapy and use of diabetes technology, as well as the use of telemedicine
capabilities. International comparisons show that in centers where pediatric and internal
medicine diabetes teams provide age-appropriate care within the same treatment facility,
the transition is much less complicated and people with type 1 diabetes benefit from
shared experience in the use of diabetes technologies across the lifespan. However,
the implementation of such concepts under the framework of the German health care
system requires a rethinking among the involved stakeholders and does not seem promising
without pressure from the affected people with type 1 diabetes.
Schlüsselwörter Typ-1-Diabetes - Transition - Insulinpumpen - Glukosesensoren
Key words type 1 diabetes - transition - insulin pumps - glucose sensors
