Transition from pediatric to adult care for patients with type 1 diabetes mellitus: more than just a handover.
TL;DR
Evidence supports transition as a structured, individualized, and developmentally appropriate process rather than a single transfer of care rather than a single transfer of care for young adults with T1D.
Abstract
Type 1 diabetes (T1D) is a chronic autoimmune disease that commonly presents during childhood or adolescence and requires lifelong multidisciplinary care. The transition from pediatric to adult diabetes services is a pivotal stage often accompanied by poorer glycemic control, reduced clinic attendance, and increased risk of disengagement from healthcare. This review summarizes current evidence on the principles, challenges, and effective strategies for transitioning adolescents and young adults with T1D from pediatric to adult care. A review of the literature was conducted, focusing on transition models, clinical and psychosocial outcomes, and recommendations from the International Society for Pediatric and Adolescent Diabetes (ISPAD) and other relevant studies. Evidence supports transition as a structured, individualized, and developmentally appropriate process rather than a single transfer of care. Successful transition programs incorporate early preparation, multidisciplinary collaboration, joint pediatric-adult care, transition coordinators, psychosocial support, and progressive patient autonomy. These approaches improve continuity of care, self-management, clinic attendance, and glycemic outcomes while reducing loss to follow-up. Although transition care is increasingly recognized as a key component of T1D management, its implementation remains inconsistent. Wider adoption of standardized, evidence-based transition pathways is needed to optimize long-term health outcomes for young adults with T1D.