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Journal Insights Into: Recommendations for Transition from Pediatric to Adult Diabetes Care Systems. Supplemental Slides. Transition from Pediatric to Adult Care Challenges. Lack of empirical evidence Differences between pediatric and adult healthcare providers (HCPs)
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Journal Insights Into: Recommendations for Transition from Pediatric to Adult Diabetes Care Systems Supplemental Slides
Transition from Pediatric to Adult CareChallenges • Lack of empirical evidence • Differences between pediatric and adult healthcare providers (HCPs) • Difficulty in determining readiness for transition • Social and demographic changes • Health insurance gaps • Unique learning styles of emerging adults • Lack of HCP training regarding emerging adults Peters A, et al. Diabetes Care. 2011;34:2477-2485.
Transition from Pediatric to Adult CareEmerging Adulthood • 18–30 years of age • A time of transition • Geographic • Economic • Emotional • Many priorities – prevent focus on diabetes care • Lack of skills to manage diabetes Peters A, et al. Diabetes Care. 2011;34:2477-2485.
Transition from Pediatric to Adult Care“A Perfect Storm” • Differences between pediatric and adult care • Poor glycemic control • Lack of follow-up • Psychosocial issues • Sexual/reproductive issues • Alcohol, smoking, drug use • Acute and chronic complications of diabetes Peters A, et al. Diabetes Care. 2011;34:2477-2485.
Transition from Pediatric to Adult CareSelected Recommendations • Prepare patient for transition ahead of time • Provide written summary for adult care provider • Provide assistance for patient (eg, patient navigator) • Individualize care to patient’s developmental level • Address eating disorders and affective disorders • Screen for microvascular and macrovascular complications • Address high-risk behaviors Peters A, et al. Diabetes Care. 2011;34:2477-2485.
Take-Home Messages • Maintaining continuity of care from pediatric to adult care is key to successful transition • Prepare patient for transition • Overlap between internist and pediatrician (bridge from pediatric to adult care) • Educate emerging adults • Additional research is needed to determine best practices