Transition to adult care for youth with type 1 diabetes

Abstract

Emerging adults with type 1 diabetes are at risk for poor glycemic control, gaps in medical care, and adverse health outcomes. With the increasing incidence in type 1 diabetes in the pediatric population, there will be an increase in the numbers of teens and young adults transferring their care from pediatric providers to adult diabetes services in the future. In recent years, the topic of transitioning pediatric patients with type 1 diabetes to adult diabetes care has been discussed at length in the literature and there have been many observational studies. However, there are few interventional studies and, to date, no randomized clinical trials. This paper discusses the rationale for studying this important area. We review both observational and interventional literature over the past several years, with a focus on new research. In addition, important areas for future research are outlined.

Fig. 1

From family-managed diabetes care to shared care to self-care. In childhood, parents are responsible for all of diabetes management. As youth get older, they begin to take on more responsibility for their care while the family continues to provide support and supervision. Eventually, older teens and young adults assume full responsibility for diabetes self-care behaviors, although family support remains helpful for patients of all ages throughout the lifespan

Fig. 2

Constellation of factors influencing healthcare transition in emerging young adults with type 1 diabetes. Multiple factors likely influence the success of healthcare transition from pediatric to adult diabetes care teams. A successful transition will lead to improved health outcomes. Additional research is needed to identify the optimal approaches to ensure a successful transition