Moving On: Transition of Teens With Type 1 Diabetes to Adult Care

Psychiatric disorders during early adulthood in those with childhood onset type 1 diabetes: Rates and clinical risk factors from population-based follow-up

“…The transition to adulthood presents many challenges including establishing new social networks and increased independence; those with chronic diseases experience additional challenges including taking over primary communication with their health care team and increased accountability for disease management . For those with T1D, this period generally coincides with a change of diabetes management providers from paediatric care to adult or general practitioner lead care . All of these changes occur during a time (ages 18‐34 years) when the prevalence of many psychiatric disorders peaks…”

Technology Use in Transition-Age Patients With Type 1 Diabetes

“…22 Psychosocial factors impacting diabetes management have been identified as depressive symptoms, 23 anxiety or avoidance, 24 learning difficulties, 25 diabetes burnout, 26 life satisfaction, perceived stress, global well-being, 22 combinations of life transitions/change, diabetes self-efficacy, and demonstration of diabetes self-management. 27 Research continues to demonstrate that untreated psychosocial stressors are a moderator of optimal diabetes management. 22 In addition, roughly two-thirds (65%) of transition-age youth indicate they have experienced at least 1 unfavorable medical outcome due to suboptimal access to medical care.…”

Family Perspectives of Components of a Diabetes Transition Program

“…Unfortunately, if there is incongruence between the adolescent and the parent's beliefs about the importance of abilities and behaviors needed for transition, it is unlikely that the adolescent will learn to carry out self-management behaviors independently. These incongruent beliefs can cause conflict between the parents, providers and adolescents and may contribute to the reason that adolescents are lost to follow up so often during this transition process (Daneman & Nakhla, 2011). Science reinforces why these behaviors are important and can negatively impact health, but providers and parents should be aware of what the adolescent believes is important.…”

“…Utilizing a bridge approach where members of the pediatric team participate in early transition visits has been shown to be helpful (Hilliard et al, 2014) and may facilitate this communication and connection during the transition to adult services. In programs where a member of the pediatric team was part of the transitioning adult team there were decreased episodes of hospitalization for diabetic ketoacidosis (DKA) than when the adolescent was transitioned to a completely new team (Daneman & Nakhla, 2011).…”

“…In centers with transition plans, 4% of respondents felt completely unprepared for transition while 7% stated they were mostly unprepared and 26% were neutral in how prepared they felt for transition (Garvey, Wolpert et al, 2012). In a review of multiple studies of adolescent transition outcomes, in pediatric centers without a formal transition process 20-25% failed to seek follow up care in the 2-4 years after leaving the pediatric practice (Daneman & Nakhla, 2011).…”