Background <p>Multiple socio-cultural and personal factors influence the transition from pediatric to adult-centered diabetes care in youth-onset type 1 diabetes (Y-T1D), but few data exist in youth-onset type 2 diabetes (Y-T2D). We determined the scope of the literature on socio-ecological factors associated with transitioning to adult care in Y-T2D compared with Y- T1D to identify facilitators, barriers, and knowledge gaps in Y-T2D.</p> Method <p>We conducted a global scoping review using the Systematic Reviews and Meta-Analyses for scoping reviews (PRISMA-ScR) guidelines. Eligible articles were peer-reviewed experimental and quasi-experimental articles published between January 1990 and September 2022, with no language restrictions.</p> Results <p>In 104 articles that reported on transitioning to adult care, 88% were in Y-T1D, 6% compared Y-T1D and Y-T2D, 2% reported in Y-T2D only, and 4% reported on youth-onset diabetes diagnosis. The proportion of articles that reported on socio-ecological domains were similar in Y-T1D compared to articles that included Y-T2D. Identified challenges associated with the transitioning period in Y-T2D were societal (structural bias, poverty, inadequate social support), health cultural (limited access to adult health-care providers), psychological (feelings of anxiety and fear of transition), and behavioral (difficulty with medication adherence). The transition period was associated with worsening glycemic control in both groups.</p> Conclusions <p>Y-T2D face multiple challenges across socio-ecological domains during the transition to adult-centered diabetes care. However, only 8% of studies on transitioning factors included Y-T2D and additional research is needed to develop dynamic and robust transition programs in Y-T2D.</p> Scoping review registration <p>Protocol was registered with Open Science Framework, April 4, 2022. <a href="https://osf.io/k2pwc">https://osf.io/k2pwc</a>.</p>

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Transitioning to adult care in youth-onset diabetes: a scoping review of socio-ecological factors in youth-onset type 2 diabetes compared to type 1 diabetes

  • Assumpta O. Ude,
  • Sydney A. Dixon,
  • Sophia B. Glaros,
  • Sue-Ann Arboine,
  • Nancy L. Terry,
  • Tomás Cabeza De Baca,
  • Stephanie T. Chung

摘要

Background

Multiple socio-cultural and personal factors influence the transition from pediatric to adult-centered diabetes care in youth-onset type 1 diabetes (Y-T1D), but few data exist in youth-onset type 2 diabetes (Y-T2D). We determined the scope of the literature on socio-ecological factors associated with transitioning to adult care in Y-T2D compared with Y- T1D to identify facilitators, barriers, and knowledge gaps in Y-T2D.

Method

We conducted a global scoping review using the Systematic Reviews and Meta-Analyses for scoping reviews (PRISMA-ScR) guidelines. Eligible articles were peer-reviewed experimental and quasi-experimental articles published between January 1990 and September 2022, with no language restrictions.

Results

In 104 articles that reported on transitioning to adult care, 88% were in Y-T1D, 6% compared Y-T1D and Y-T2D, 2% reported in Y-T2D only, and 4% reported on youth-onset diabetes diagnosis. The proportion of articles that reported on socio-ecological domains were similar in Y-T1D compared to articles that included Y-T2D. Identified challenges associated with the transitioning period in Y-T2D were societal (structural bias, poverty, inadequate social support), health cultural (limited access to adult health-care providers), psychological (feelings of anxiety and fear of transition), and behavioral (difficulty with medication adherence). The transition period was associated with worsening glycemic control in both groups.

Conclusions

Y-T2D face multiple challenges across socio-ecological domains during the transition to adult-centered diabetes care. However, only 8% of studies on transitioning factors included Y-T2D and additional research is needed to develop dynamic and robust transition programs in Y-T2D.

Scoping review registration

Protocol was registered with Open Science Framework, April 4, 2022. https://osf.io/k2pwc.