From adolescence to adulthood: understanding type 1 diabetes transition care needs

Research from McGill University looks at improving transition from paediatric to adult diabetes care

By Sienna Russell-Green

Adolescents (teenagers) experience many changes over a relatively short period of time. Living with type 1 diabetes can make these years even more challenging. This may be for several reasons. However, research shows that the transition from child to adult diabetes care also plays a role. A successful transition is one where teenagers easily move from child to adult care. As a result, they gain new knowledge and develop independent self-care skills. This is an important step in the type 1 diabetes healthcare journey. Yet studies show a lack of progress in transition care delivery.

In this study, researchers wanted to understand what needs to improve during transition. They interviewed 65 teenagers, aged 17 years, who were in their final year of care at the children’s clinic: 64% were female. On average, they had lived with type 1 diabetes for 9 years.

Researchers found 3 major themes in their analysis:

  1. Navigating changes in roles and relationships.
    • Teenagers want more independence, and for their parents to be more supportive as diabetes care shifts from parent to child.
    • They worry that adult diabetes care will not be personalised to their needs.
  1. Self-management of type 1 diabetes.
    • They are still adapting to their new responsibilities; some are struggling to manage diabetes self-care tasks alongside other priorities.
    • Teenagers who were diagnosed at a younger age feel they have had more time to adjust to living with diabetes. Those who were diagnosed later are still not completely comfortable with their diabetes self-care.
  1. Responsibilities for preparing for transition.
    • They want more information about what to expect during and after transition to adult care.
    • They need to practice being more independent with their diabetes self-care to prepare for transition to adult care. For example, in their navigation of the healthcare system.

These findings are valuable in understanding how to improve transition care to support adolescents with type 1 diabetes. They may also reflect transition care needs across among young people with other chronic conditions.

This study suggests that transition care programs need to address changes in roles and personal relationships, diabetes self-care, and navigating the healthcare system, supported by parents and other young people.

If you enjoyed this blog, check out our other posts on adolescents.   

If you are looking for more information and support, check out our NDSS* guide for young adults with diabetes: ‘Moving On Up’.

Ladd JM, Reeves-Latour J, Dasgupta K, Bell LE, Anjachak, Nakhla M. Toward a better understanding of transition from paediatric to adult care in type 1 diabetes: A qualitative study of adolescents. Diabetic Medicine. 2022. 39(5) doi:10.1111/dme.14781

*The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered with the assistance of Diabetes Australia.

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