Transition from pediatric to adult care in emerging adults with type 1 diabetes: a blueprint for effective receivership

被引:28
|
作者
Jennifer Iyengar
Inas H. Thomas
Scott A. Soleimanpour
机构
[1] University of Michigan Health System,Diabetes Transition Program
[2] Division of Metabolism,undefined
[3] Endocrinology & Diabetes and Department of Internal Medicine of the University of Michigan Medical School,undefined
[4] Division of Endocrinology and Department of Pediatrics and Communicable Disease of the University of Michigan Medical School,undefined
来源
Clinical Diabetes and Endocrinology | / 5卷 / 1期
关键词
Transition; Complications; Hemoglobin A1c; Diabetes-related distress;
D O I
10.1186/s40842-019-0078-7
中图分类号
学科分类号
摘要
For adolescents and emerging adults, the transition from pediatrics to adult care is fraught with challenges both inside and outside the clinical arena, including assuming independent care for diabetes, working with new adult providers, and overcoming concomitant psychosocial issues, while maintaining work/school-life balance. Not surprisingly, glycemic control in emerging adults with type 1 diabetes is amongst the worst in all age groups. Thus, new and comprehensive strategies are needed by both pediatric and adult diabetes care teams to support young adults during the transition to adult care. In this review, we focus on challenges during the transition period and provide evidence-based recommendations for a receivership model to assist adult diabetes care teams in addressing these concerns. By coordinating efforts with pediatrics providers, identifying strengths and deficiencies in self-care, establishing rapport with young adult patients, directly addressing prevalent psychosocial concerns, and developing a team-based approach to keep patients engaged, adult care teams can prioritize support for the most vulnerable transition patients. Improved strategies to propel emerging adult patients through the transition period towards habits leading to optimal glycemic control could have a major long-term impact on preventing diabetes-related complications.
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