Facilitating the transition from paediatric to adult care services.

Children may gradually shift gradually from diabetes care supervised by parents and other adults to self-care management. The actual change from paediatric to adult health care providers can be more abrupt.

Clinical question:

In children with diabetes, how should the transition to adult care be managed by care systems?

This consensus statement provides a framework for health care delivery during the transition period and an agenda for future research.

The evidence:

The statement addresses:

  • Differences between paediatric and adult care
  • Poor control of glycemic and other risk factors
  • Loss to follow-up
  • Increased risk for acute complications
  • Psychosocial issues
  • Sexual and reproductive health issues
  • Alcohol, smoking, and drug abuse
  • Emergence of signs of chronic diabetes complications
  • Approaches to improve transitions in care
  • Recommendation for transition of emerging adults with diabetes.

It is endorsed by the American Diabetes Association, with representation by the American College of Osteopathic Family Physicians, the American Academy of Pediatrics, the American Association of Clinical Endocrinologists, the American Osteopathic Association, the Centers for Disease Control and Prevention, Children with Diabetes, The Endocrine Society, the International Society for Pediatric and Adolescent Diabetes, Juvenile Diabetes Research Foundation International, the National Diabetes Education Program, and the Pediatric Endocrine Society (formerly Lawson Wilkins Pediatric Endocrine Society).

Appraisal hints:

  • Does this guidance conform to the AGREE recommendations for guideline development?
  • Service configuration may differ significantly in your setting.


The full text can be downloaded from Diabetes Care:

Peters A, Laffel L & The American Diabetes Association Transitions Group. Diabetes care for emerging adults: recommendations for transition from pediatric to adult diabetes care systems.  Diabetes Care. 2011 Nov;34(11):2477-85.

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I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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