Transition to adult endocrine services: What is achievable? The diabetes perspective

Transition to adult diabetes care in Germany-High risk for acute complications and declining metabolic control during the transition phase

“…That means that 50% of all patients with microalbuminuria are not treated adequate. Structured transition programs with case management seem to improve the process especially in high risk patients . Not in all places a face to face transition clinic can be run .…”

“…In a survey in Germany we could find a high rate of unsatisfactory transfers of adolescents with T1D to adult health care services, with some patients even dropping out of the medical system . Recently, several reviews have tried to summarize the evidence of randomized controlled trials (RCTs) and other trials in the field of transition of adolescents and young adults from pediatric to adult diabetes care . There is still only a small number of high quality studies available.…”

“…Transfer appears to be associated with decreased attendance. However, there is growing evidence for the impact of structured and guided transition programs . Predictors for a successful transition were more intensified insulin treatment, better metabolic control, more visits in the pediatric department before transfer and more focus on the transition process .…”

“…4 Recently, several reviews have tried to summarize the evidence of randomized controlled trials (RCTs) and other trials in the field of transition of adolescents and young adults from pediatric to adult diabetes care. 4,5 There is still only a small number of high quality studies available. Transfer appears to be associated with decreased attendance.…”

“…However, there is growing evidence for the impact of structured and guided transition programs. 5,6 Predictors for a successful transition were more intensified insulin treatment, better metabolic control, more visits in the pediatric department before transfer and more focus on the transition process. 7 Especially, adolescents with poor metabolic control and a history of severe hypoglycemia have a higher mortality risk in early adulthood.…”