Strategies to Guide Paediatric Type 1 Diabetes Management and Transition of Care: A State-Of-The-Art Review

Abstract

Aim: The aim of the study was to synthesise current evidence on the transition of type 1 diabetes management responsibility from caregiver to child.

Design: A state-of-the-art review was conducted.

Methods: Using Rayyan software, two authors independently performed the study selection.

Data sources: CINAHL, PubMed and Web of Science databases were searched to identify relevant articles that focused on children ages 1-19 who were transitioning care of paediatric type 1 diabetes. The last search was performed on 17 October 2023.

Results: Thirty-seven studies conducted in four different countries were included following abstract screening, full-text review and assessment for risk of bias-23 quantitative, 13 qualitative and one mixed method. One study examined early childhood transition, five studies examined middle childhood and 31 studies examined transition strategies utilised in later childhood. Themes in clinician and caregiver transition interventions were identified.

Conclusion: Findings can inform the development and refinement of transition interventions to help clinicians and caregivers ensure a successful transition of type 1 diabetes management to the paediatric patient.

Implications for the profession and patient care: A rigorous investigation to validate strategies for different age groups is needed. To support this process and improve type 1 diabetes mellitus outcomes for paediatric patients, research and recommendations should be further reviewed to assist in tailoring interventions accordingly.

Impact statement: Effective transition management strategies to shift responsibility from caregiver to child are increasingly important to ensuring safe self-management of paediatric type 1 diabetes. Reviews on type 1 diabetes transition management strategies for youth are needed. In this systematic review, we highlight transition strategies for children ages 1-19 who were transitioning care of paediatric type 1 diabetes. Findings offer insight on long-term diabetes management to improve patient outcomes in paediatric patients with type 1 diabetes.

Reporting method: We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Patient or public contribution: No patient or public contribution was required in this review.

Keywords: diabetes mellitus complications; paediatric nursing; paediatric transition to adult care; self‐management; transitional care; type 1 diabetes mellitus.