Poor prognosis of young adults with type 1 XXXX : a longitudinal study.

@entity1 @entity644 @entity8 @entity6 @entity146 @entity1897 @entity4148 @entity989
OBJECTIVE: To determine the role of early behavioral and psychological factors on later outcomes in young adults with childhood- or adolescent-onset type 1 @entity6 . RESEARCH DESIGN AND METHODS: We conducted a longitudinal cohort study of @entity1 recruited from the register of the young adult outpatient @entity6 clinic, Oxford, U.K. A total of 113 individuals (51 male subjects) aged 17-25 years completed assessments, and 87 (77%) were reinterviewed as older adults (aged 28-37 years). Longitudinal assessments were made of glycemic control (HbA(1c)) and complications. Psychological state at baseline was assessed using the Present State Examination and self-report Symptom Checklist, with corresponding interview schedules administered at follow-up. RESULTS: There was no significant improvement between baseline and follow-up in mean HbA(1c) levels (8.5 vs. 8.6% in @entity1 , 9.3 vs. 8.7% in @entity1 ). The proportion of individuals with serious complications (preproliferative or laser-treated @entity989 , @entity644 or more severe @entity8 , @entity1897 , and @entity4148 ) increased from 3-37% during the 11-year period. @entity1 were more likely than @entity1 to have multiple complications (23 vs. 6%, difference 17%, 95% CI 4-29%, P = 0.02). @entity146 increased from 16 to 28% (20% in @entity1 , 36% in @entity1 at follow-up, difference NS), and 8% had @entity146 at both assessments. Baseline @entity146 symptom scores predicted follow-up scores (beta = 0.32, SE [beta] 0.12, P = 0.008, 95% CI 0.09-0.56) and recurrent admissions with @entity6 (odds ratio 9.1, 95% CI 2.9-28.6, P < 0.0001). CONCLUSIONS: The clinical and @entity146 outcome in this cohort was poor. Psychiatric symptoms in later adolescence and young adulthood appeared to predict later @entity146 problems.
