Transition of the adolescent from the children's to the adults' diabetes clinic

Abstract

The transition of adolescents with type 1 diabetes mellitus (T1DM) from pediatric to adult diabetological care is a critical phase that requires special attention. A considerable proportion of adolescents encounters certain difficulties during this transition, which can negatively affect adjustment and glycemic control. Etiological factors include: (a) the adolescent's separation anxiety elicited by the process of departing from the pediatrician who functions as a secure base in a period of developmental turmoil; (b) certain developmental factors that adversely affect glycemic control and the patient-physician cooperation; (c) the tendency of the adult diabetologist to focus more on medical than on psychosocial components; (d) the lack of the appropriate preparatory work which would: (i) help the adolescent to successfully cope with the difficulties that may arise due to the transition and (ii) make feasible the establishment of the proper pediatrician-adult diabetologist cooperation required for the development of a continuum in diabetological care through which the adolescent's special needs can be best met. Practical propositions about certain basic problem-solving components concerning the transition from the pediatric to adult diabetes clinic are briefly discussed.