Current methods of transfer of young people with Type 1 diabetes to adult services

Abstract

Adolescence is a vulnerable period for patients with diabetes. This regional survey demonstrated a marked decline in clinic attendance around the time of transition from paediatric to adult services. The reasons are complex, but mode of transfer may be an important factor.

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

“…This recommendation is supported by Grade C evidence, Level 3,4 but it fails to provide advice on the more practical hows and whens of transition.…”

“…Table 2 summarizes the major intervention studies. 4,[13][14][15][16][17] In essence, interventions aimed at decreasing loss to follow-up achieve this aim. However, no studies show a better outcome in terms of metabolic control, psychosocial adjustment, complication rates, or other metabolic or medical indicators.…”

“I look forward. I feel insecure but I am ok with it”. The experience of young HIV+ people attending transition preparation events: a qualitative investigation

“…Poorer clinical outcomes have been identified in other disease areas (e.g. diabetes, juvenile arthritis, cancer) where the process of transition was not emphasized including poorer out-patient clinic attendance, poorer adherence to treatment and increased morbidity and mortality (Prime et al, 2001;Martinez et al, 2000;Kipps et al, 2002;Weiner et al, 2007 (Bitsindou et al, 2007;Lesch et al, 2007 (Judd et al, 2007) and live in families which face multiple challenges e.g. immigration issues, housing, employment and educational difficulties, stigma and discrimination (Green and Smith, 2003;Waugh, 2003).…”

Transition Care for Children With Special Health Care Needs

“…36,41 The remainder studied a variety of conditions including congenital adrenal hyperplasia, 21 HIV, 24 epilepsy, 25 juvenile idiopathic arthritis, 38 spina bifida, 42 cystic fibrosis, 37 or inflammatory bowel disease 43 or included a patient population comprising .1 chronic disease. 20,35,44 Twelve studies were conducted in Europe: 8 in the United Kingdom, 21,22,29,32,35,36,39,50 1 in Germany, 33 1 in Spain, 40 and 2 in 26 One study included data from the United Kingdom and Australia. 24 Few studies used a concurrent comparison group.…”