Impact of Evolving Life Circumstances on Emerging Adults with Type 1 Diabetes: Discoveries from the Tübingen Transition Study After 22 Years

Aims: Transition from pediatric to adult care present challenges for patients with chronic diseases. Objective of the study was to identify factors associated with metabolic control in childhood-onset type 1 diabetes (T1D) following transfer to adult care. Additionally, we aimed to characterize sociodemographic parameters, and to compare these data with those of the general population. Methods: Contact of 281 patients transferred from pediatric to adult care between 1998 and 2021 yearly by questionnaire to provide information regarding their current hemoglobin A1c (HbA1c), type of care, type of therapy, occupational situation, living situation, marital status, and parental status. Analyze data using a mixed cross-sectional-longitudinal approach. Results: 205 patients responded at least once (mean age: 27.7 years). Women were more frequently treated with pump therapy than men (p<0.05). HbA1c levels reported by men did not significantly differ from those reported by women before and after transfer. Individuals employed in academic jobs after transfer had significantly lower HbA1c levels before and after transfer than those who worked in non-academic jobs, while the differences between individuals who were in vocational training and those pursuing studies were most pronounced (7.4±1.0%, 57±13 mmol/mol vs. 7.0±0.8%, 53±15 mmol/mol, p<0.05). Moreover, among individuals aged 30 to 40, those with T1D exhibited a lower prevalence of having children (38.0% vs. 52.7%) and being married (40.5% vs. 55.3%) compared to general population. Conclusions: Psychosocial life circumstances that are considered more stable in early adulthood, such as being a parent and working in academic occupation, were positively associated with metabolic control.