Diabetes care for emerging adults: recommendations for transition from pediatric to adult diabetes care systems
Open accessAbstract
During childhood and adolescence, there is a gradual shift from diabetes care supervised by parents and other adults to self-care management. The actual change from pediatric to adult health care providers signals a more abrupt change that requires preparation by patients, their families, and their health care providers. A number of publications from the U.S. and other countries have highlighted substantial gaps in care during this transition period between pediatric and adult care that often arise in later adolescence and the subsequent developmental stage of life termed “emerging adulthood.” This is a critical time when patients not only assume responsibility for their diabetes self-care and interactions with the health care system but when they become more independent, potentially moving out of their parents’ home to attend college or to join the workforce (1). In the context of these transitions and the developmental issues of this age-group, gaps in diabetes care can result in suboptimal health care utilization, deteriorating glycemic control, increased occurrence of acute complications, emergence of chronic complications of diabetes that may go undetected or untreated, and psychosocial, behavioral, and emotional challenges. With the increasing incidence of both type 1 and type 2 diabetes in childhood, adolescence, and young adulthood, there is an increase in the absolute numbers of youth with diabetes in this transition period, highlighting the need for a framework of care and education for this population and a call for additional research in this area. Substantial challenges relating to the transitional period include the following:
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Lack of confidentiality is known to worsen adolescents' health behavior, particularly for taboo or risky behaviors.
“Care should be taken to respect a teen/young adult’s privacy, as lack of confidentiality is known to negatively affect adolescents’ health behavior, especially regarding what are considered taboo or risky behaviors (101).”
From Psychosocial care for people with diabetes: a position statement of the American Diabetes Association (2016) · cites this paper as [101]
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- Authors
- Peters, A., Laffel, L., & the American Diabetes Association Transitions Working Group
- Affiliations
- University of Southern California (US)
- Joslin Diabetes Center (US)
- Corresponding author
- Laffel, Lori
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-10-15
- Volume
- 34
- Issue
- 11
- Pages
- 2477-2485
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3198284
- OpenAlex
- W1819182952
- Cited by
- 581
- References
- 80
- Citations by year
- 2026: 25 · 2025: 37 · 2024: 27 · 2023: 38 · 2022: 52 · 2021: 38 · 2020: 47 · 2019: 52 · 2018: 53 · 2017: 32 · 2016: 44 · 2015: 46 · 2014: 37 · 2013: 38 · 2012: 13
- FWCI
- 67.14
- Type
- journal article
- Language
- en
- Update notices
- correction (2012-01-01)
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- American Diabetes Association
- Bristol-Myers Squibb
- Eli Lilly and Company
- AstraZeneca
- Sanofi
- Kaiser Permanente
- University of Minnesota
- University of Washington
- University of South Florida
- Dexcom
- York University
- Novo Nordisk
- Centers for Disease Control and Prevention
- Abbott Diabetes Care
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK095273)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- emerging adults, care transitions, transition to adult care, diabetes management, clinical guidelines
- MeSH terms
- Adolescent, Adult, Child, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Humans, Pediatrics, Physicians, Self Care, Societies, Medical, Young Adult, Transition to Adult Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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