Improving transition of care from pediatric to adult endocrinology for adolescents with diabetes

Abstract

Introduction: Adolescence is a challenging time in a child's life and can be even more stressful for those with a chronic medical condition such as diabetes mellitus. Adolescents and young adults with type 1 and type 2 diabetes experience worsening glycemic levels as they enter adulthood. Data suggest that a formalized health care transition process and beginning transition preparation in early adolescence leads to better transition outcomes.

Methods: The aim of this study was to create a transition of care program for youth with diabetes in a standalone children's hospital by following the Got Transition Six Core Elements of Health Care Transition. First, we implemented a transition of care policy and formalized how we discussed transition of care with patients and families in early adolescence. Further improvements have included assessing readiness to transition, designing a curriculum centered around adolescent-specific issues and how they relate to diabetes management, and forming connections with adult endocrinologists in the area to establish a seamless transition process.

Results: After implementing our program, 90 % (28/31) of our patients indicated they were very or somewhat ready to transition to adult care.

Discussion: We outline our process for developing a transition of care program and provide a practical tool for other pediatric diabetes providers who are interested in implementing a similar program.

Keywords: Adolescents; Diabetes; Pediatric; Transition; Type 1 diabetes.

Fig. 1

Our clinic’s transition of care process based on the Six Core Elements.