Abstract：
BACKGROUND: The transition from paediatric to adult diabetes care (TPA) of children/adolescents with type 1 diabetes (T1D) represents a unique challenge and remains a critical phase in the T1D care pathway. This study aims to describe and understand the experience of the transition process from a participant\'s perspective in young adults who are living in France with T1D and to measure their satisfaction.
METHODS: An online questionnaire was presented to people with T1D in France on a global online participant community platform. The questionnaire was developed by a scientific committee including paediatric and adult diabetologists and refined by a group of participants. Thematic qualitative analysis was performed on the responses.
RESULTS: A total of 104 respondents were included in the survey (mean age 24.4 years [95% CI 23.8-25.0]; 61.5% female). The mean age at the time of transition was 18.4 years (95% CI 17.8-18.9), and 56% of respondents had their first adult diabetology follow-up in the same institution. During TPA, of the 76 participants who experienced personal issues, 74% experienced at least one issue with their diabetes management in the months following the transition. In the following months, 61% experienced new or unexpected problems in monitoring their diabetes after transition and 44% reported unusual glycaemic imbalances, including hypoglycaemia (8%) and hyperglycaemia (9%) requiring hospitalisation. Presence of personal issues during TPA was significantly associated with occurrence of problems with diabetes management or glycaemic imbalance. Three factors identified for a successful transition were (i) early meeting with the \'adult\' diabetes care team, (ii) letting the participants choose the right age to leave paediatric clinic and (iii) having good diabetes control at the beginning of the TPA process.
CONCLUSIONS: Most young adults with T1D report experiencing issues around TPA with significant consequences on their disease management. Hence, it is necessary to identify these issues to better support them and improve diabetes management during this phase.
METHODS: An online questionnaire was presented to people with T1D in France on a global online participant community platform. The questionnaire was developed by a scientific committee including paediatric and adult diabetologists and refined by a group of participants. Thematic qualitative analysis was performed on the responses.
RESULTS: A total of 104 respondents were included in the survey (mean age 24.4 years [95% CI 23.8-25.0]; 61.5% female). The mean age at the time of transition was 18.4 years (95% CI 17.8-18.9), and 56% of respondents had their first adult diabetology follow-up in the same institution. During TPA, of the 76 participants who experienced personal issues, 74% experienced at least one issue with their diabetes management in the months following the transition. In the following months, 61% experienced new or unexpected problems in monitoring their diabetes after transition and 44% reported unusual glycaemic imbalances, including hypoglycaemia (8%) and hyperglycaemia (9%) requiring hospitalisation. Presence of personal issues during TPA was significantly associated with occurrence of problems with diabetes management or glycaemic imbalance. Three factors identified for a successful transition were (i) early meeting with the \'adult\' diabetes care team, (ii) letting the participants choose the right age to leave paediatric clinic and (iii) having good diabetes control at the beginning of the TPA process.
CONCLUSIONS: Most young adults with T1D report experiencing issues around TPA with significant consequences on their disease management. Hence, it is necessary to identify these issues to better support them and improve diabetes management during this phase.
摘要：
背景：儿童/青少年1型糖尿病（T1D）从儿科到成人糖尿病护理（TPA）的转变代表了一个独特的挑战，并且仍然是T1D护理途径的关键阶段。本研究旨在从参与者的角度描述和理解生活在法国患有T1D的年轻人的过渡过程的经验，并衡量他们的满意度。
方法：在全球在线参与者社区平台上向法国的T1D患者提供了在线问卷。问卷是由包括儿科和成人糖尿病专家在内的科学委员会开发的，并由一组参与者完善。对答复进行了专题定性分析。
结果：共有104名受访者被纳入调查（平均年龄24.4岁[95%CI23.8-25.0]；61.5%女性）。过渡时的平均年龄为18.4岁（95％CI17.8-18.9），56%的受访者在同一机构进行了首次成人糖尿病学随访。在TPA期间,在经历过个人问题的76名参与者中，74％的人在过渡后的几个月中经历了至少一个糖尿病管理问题。在接下来的几个月里，61％的人在过渡后监测糖尿病时遇到了新的或意外的问题，44％的人报告了不寻常的血糖失衡。包括需要住院治疗的低血糖(8%)和高血糖(9%)。TPA期间个人问题的存在与糖尿病管理或血糖失衡的问题的发生显着相关。成功过渡的三个因素是（i）与成人糖尿病护理团队的早期会面，（ii）让参与者选择合适的年龄离开儿科诊所，以及（iii）在TPA过程开始时具有良好的糖尿病控制。
结论：大多数患有T1D的年轻人报告在TPA周围出现问题，对他们的疾病管理产生重大影响。因此，有必要识别这些问题,以更好地支持这些问题,并在这一阶段改善糖尿病管理.
方法：在全球在线参与者社区平台上向法国的T1D患者提供了在线问卷。问卷是由包括儿科和成人糖尿病专家在内的科学委员会开发的，并由一组参与者完善。对答复进行了专题定性分析。
结果：共有104名受访者被纳入调查（平均年龄24.4岁[95%CI23.8-25.0]；61.5%女性）。过渡时的平均年龄为18.4岁（95％CI17.8-18.9），56%的受访者在同一机构进行了首次成人糖尿病学随访。在TPA期间,在经历过个人问题的76名参与者中，74％的人在过渡后的几个月中经历了至少一个糖尿病管理问题。在接下来的几个月里，61％的人在过渡后监测糖尿病时遇到了新的或意外的问题，44％的人报告了不寻常的血糖失衡。包括需要住院治疗的低血糖(8%)和高血糖(9%)。TPA期间个人问题的存在与糖尿病管理或血糖失衡的问题的发生显着相关。成功过渡的三个因素是（i）与成人糖尿病护理团队的早期会面，（ii）让参与者选择合适的年龄离开儿科诊所，以及（iii）在TPA过程开始时具有良好的糖尿病控制。
结论：大多数患有T1D的年轻人报告在TPA周围出现问题，对他们的疾病管理产生重大影响。因此，有必要识别这些问题,以更好地支持这些问题,并在这一阶段改善糖尿病管理.
