Transitioning from pediatric to adult diabetes health care

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An overview of helping your child make the transition from pediatric to adult diabetes care. Find out when they should start transitioning and what to expect in the future.

Key points

  • Your child should begin to transition to adult care as soon as they are confident and responsible enough to move forward, typically between the ages of 16 and 20 years.
  • Help your teen prepare to transfer by encouraging them to take an active role in their own diabetes care.
  • Your teenager should have regular tests to check for complications of diabetes. They should continue to be screened for complications as adults.

​​There comes a time when the teenager with diabetes needs to link up with a team experienced in the care of adults.

This transition can be quite emotional and stressful for all. Moving on to a new health-care setting is like graduating from high school to college. Over a short period of time, the teenager shifts from being the biggest, oldest, and wisest person to being a young, inexperienced rookie in a larger and different environment. Some find the experience exciting. Others prefer the security of the old setting. What the team expects of your teen is different between pediatric and adult care. In the adult system, young adults are expected to have complete responsibility for themselves.

As teenagers enter the adult system, many are surprised by the demands placed on them. They are responsible for booking and following up on their own appointments. If they are not already doing so, they may be expected to practise more intensive management of their diabetes, aiming for tighter blood glucose (sugar) control through more frequent insulin injections and blood sugar monitoring. There will be changes in meal plans, as they are no longer growing. Some find they are not as physically active as they used to be and have to make up for that with a more structured exercise regimen. As their risk of complications  increases with age, they may have to monitor blood pressure and see an eye doctor more frequently. They should also focus on routine foot care to prevent infections and identify signs of nerve damage.

These demands can be overwhelming. The support system of family and friends throughout this transition phase is vital to ensure that the young adult continues with the care needed to manage their diabetes.

When to make the change

Ideally, the change to adult care should come when your teenager is confident and responsible enough to move forward. Hospital or clinic policy usually dictates a transition between the ages of 16 and 20 years. You and your teenager should be aware of this well ahead of time in order to prepare. Ask your child's dia​betes team for advice.

You can help your teen make a successful transfer by encouraging them to take an active part in their diabetes care as a child and into adolescence.

  • Encourage them to solve problems and make choices about adjusting insulin doses. For example, encourage your teen to have independent visits with the diabetes team
  • Your teen may benefit from taking part in either an individual or group program (attend Transition day) before leaving the paediatric centre

Looking ahead

Over the years, high blood sugar and high blood pressure levels associated with diabetes can have an impact on a person’s body. They can lead to eye problems, heart and systemic diseases, kidney problems, and nerve damage. Careful management is the best way to prevent complications from diabetes. Your teen should:

  • Maintain the best blood sugar control possible
  • Control blood pressure
  • Maintain a healthy weight
  • Eat a healthy diet
  • Exercise regularly
  • Avoid smoking

Your teenager should have regular tests to check for complications​. The sooner complications are found, the sooner treatment can begin to prevent them from getting worse.

This is hard work. Because complications are very rare in young people, this threat rarely gets them to take action. Most young people, including those with diabetes, do not often think about their health 20 years down the road. That is where parents, caregivers, family members, and health-care professionals come in, to provide the foresight and support to help them stay on track toward a healthy future.

Last updated: September 25th 2017