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Transitioning from Pediatric to Adult Diabetes Care

L. Nicole Johnson, DrPH, MPH, MA, Stephanie T. Melton, PhD, MPH, MA, Ashley N. Wingert, MPH, CPH


Objective: The clinical transition from pediatric to adult diabetes care is often challenging for both young adults with type 1 diabetes (T1D) and the health care providers (HCPs) who care for this population. This study presents insights into the perceptions and needs of both patients with diabetes and HCPs during the clinical transition.

Research Design and Methods: Two separate surveys were administered with questions specifically tailored to each audience. Perceptions of the transition phase for both patients with T1D and HCPs were analyzed for general trends and then compared to investigate similarities and differences between patient and provider needs.

Results: Both patients and HCPs expressed concerns regarding poor patient-provider communication during transition and the barriers to independently managing diabetes self-care responsibilities (e.g. navigating insurance, ordering supplies, arranging healthcare appointments). Although 45% of HCPs reported screening transition age patients for mental health issues related to diabetes, only 9% of patients stated their provider offered this opportunity. Furthermore, patients reported facing a variety of challenges not discussed with their HCP including: sexual issues (28%), depression or anxiety (17%), and eating disorders (11%).

Conclusions: Training in the assessment of young adult T1D needs and effective communication techniques may assist HCPs in working more effectively with young adults. Offering mental health screenings for transition age patients may open the conversation to discuss diabetes concerns such as depression, sexual challenges, and eating disorders not currently being addressed. Both patients and providers desire improved communication with more emphasis on independently managing diabetes responsibilities and adjusting to new life situations.

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