The American Diabetes Association 72nd Scientific Sessions:

Easing the Transition to Adult Diabetes Care: Check in on How Adolescents Feel

Transition care in the type 1 diabetes field is garnering a lot of attention recently.  Issues include:  how to ease the transition, when to start the transition, how to individualize the transition, the role parents should play, and more.  It seems that everyone agrees that this is a crucial transition—and that there aren’t enough tools in place yet to make it a good transition for everyone.

A group recently studied how young adults who have made the transition from pediatric to adult diabetes care felt during and just after their transition.  The research was presented at the 72nd Scientific Sessions of the American Diabetes Association as the poster “Changing Patient-Provider Relationships during Transition from Pediatric to Adult Diabetes Care.”1

This was a qualitative study made up of a purposive sample of 26 type 1 diabetes patients.  They were selected by A1c levels, and the mean age was 26.2 ± 2.5 years.  They had been transitioned to adult care at 20.3 ± 3.2 years, and the mean diabetes duration was 16.3 ± 4.7 years.

The patient group was 62% female, 81% white, and 85% college educated.

There were 5 focus groups; 3 had lower A1c (n = 16, A1c = 7.4 ± 0.6%), and 2 had higher A1c (n = 10, Ac1 = 9.8 ± 1.0%).  In all groups, the discussion was recorded, transcribed, and analyzed using thematic analysis.

Themes from Focus Groups on Transition Care
Disrupted Attachment:  There was a theme of loss or sadness about leaving the pediatric practice.  These patients had, essentially, grown up with their diabetes treatment team, so leaving that setting was sad.

Partners in Care:  Many patients said that they didn’t feel as known by their adult diabetes team.  They did, however, use words like “partners” and “accountable for” when describing how they were involved in their own care; they felt like they were more responsible.

Patient-Provider Match:  The patients pointed out that it’s important to find a provider who matches your personality style; this match should not be left up to chance.  The patients should feel comfortable, supported, and understood by their providers, and a poor match can lessen these feelings.

Improving Type 1 Diabetes Transition Care
To facilitate a successful transition to adult diabetes care, the feelings of the adolescent should be taken into account:  this is a significant change in their lives, and their feelings of loss or sadness should be recognized.

Additionally, the process should begin early enough so that a good patient-provider match can be found and so that the process doesn’t feel rushed.

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