Transition From Pediatric to Adult Care for Individuals With Type 1 Diabetes: Opportunities and Challenges |
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| Affiliation: | 1. Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio;2. Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio;3. Division of Endocrinology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio;1. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York;2. Division of Endocrinology, Department of Medicine, Montefiore Einstein, Bronx, New York;3. Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York;1. Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of New Mexico, Albuquerque, New Mexico;2. Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico;3. University of New Mexico College of Pharmacy, Albuquerque, New Mexico;4. University of New Mexico Health Sciences Center, Albuquerque, New Mexico;1. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Department of Endocrinology, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom;1. Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;2. Eight-Year Program of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;3. Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;1. Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan;2. Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;3. Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan;4. Health Data Analytics and Statistics Center, Office of Data Science, Taipei Medical University, Taipei City, Taiwan;5. Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan;6. School of Health Care Administration, College of Management, Taipei Medical University, Taipei City, Taiwan;7. Institute of Health and Welfare Policy, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan |
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| Abstract: | ObjectivesType 1 diabetes (T1D) is a chronic disease with patients across the age spectrum that has high potential for morbidity and mortality. Unfortunately, patients transitioning from pediatric to adult care continue to demonstrate worsened glycemic control in part due to lack of understanding of transition of care best practices.MethodsThis review highlights the impact of existing transition of care interventions, assessment tools, and other recently published strategies for providers to consider to improve care of adolescent and young adult (AYA) patients with T1D in both hospital- and clinic-based settings.ResultsMany barriers impact patients with T1D during the transition period and disparities by race, sex, insurance status, and comorbid illness persist. As diabetic care continues to evolve and the prevalence of adolescents and young adults living with T1D increases, an intentional approach to transition of care is more pressing than ever. While current literature on transition of care models is limited, many show promise in improving clinic attendance and decreasing hospitalization. There are critical discussions that providers should lead with AYA patients to improve their outcomes and increase diabetes self-management, such as re-addressing carbohydrate counseling, sleep hygiene, and reproductive planning.ConclusionWhile further research on transition of care is needed, many care models offer the promise of improved T1D outcomes, enhancements in our approach to care, and increased value for our health care system at large. |
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