Pediatric to Adult Diabetes Care

 

Center for Health Services has developed information about transitioning from pediatric to adult health care for health care professionals, community organizations and family to help explain and promote this resource.

 

Transitioning from teenage years to adulthood can be stressful for teens with diabetes and their families. Teens and young adults need to assume more responsibility for diabetes self-management and make more independent judgments about their health care needs

 

The materials below will to help teens with diabetes make a smooth transition to adult health care. Families and health care professionals will also find these materials helpful.

 

 

Teenager to Adult Diabetes Transition Checklist

 

This checklist helps the health care provider, young adult, and family discuss and plan the change from pediatric to  adult health care. While  a variety of events may affect the actual timing when this change occurs, below is  a suggested timeline and topics for review. The young adult, family, and health care provider. 

 

1 to 2 years before anticipated transition to new adult care providers

  • Introduce the idea that transition will occur in about 1 year

  • Encourage shared responsibility between the young adult and family for:

  • Discuss with teen alone: *

  • Sexual activity and safety

  • How smoking, drugs, and alcohol affect diabetes

  • How depression and anxiety affect diabetes and diabetes care

    • Making appointments

    • Refilling prescriptions

    • Calling health care providers with questions or problems

    • Making insurance claims

    • Carrying insurance card

    • Reviewing blood sugar results with provider between visit

 

6 to 12 months before anticipated transition

  • Discuss health insurance coverage and encourage family to review options

    • Assess current health insurance plan and new options, e.g. family plan, college plan, employer plan, and healthcare.gov

    • Consider making an appointment with a case manager or social worker

    • Discussion of career choices in relationship to insurance issues

  • Encourage family to gather health information to provide to the adult care team (See Clinical Summary for New Health Care Team at www.YourDiabetesInfo.org/transitions)

  • Review health status: diabetes control, retina (eye), kidney and nerve function, oral health, blood pressure, and lipids (cholesterol)

  • Discuss with teen alone: *

    • Sexual activity and safety

    • Smoking status, alcohol, and other drug use

    • Issues of independence, emotional ups and downs, depression, and how to seek help

 

3 to 6 months before anticipated transition

  • Review the above topics

  • Suggest that the family find out the cost of current medication(s)

  • Provide information about differences between pediatric and adult health systems and what the young adult can expect at first visit

    • Patient’s responsibilities

    • Other possible health care team members such as a registered dietitian or diabetes educator

    • Confidentiality/parental involvement (e.g., HIPAA Privacy Act and parents need permission from young adult to be in exam room, see test results, discuss findings with health care providers), health care proxy

  • Help identify next health care providers if possible or outline process

  • Discuss upcoming changes in living arrangements (e.g., dorms, roommates, and/or living alone)

  • Last few visits

    • Review and remind of above health insurance changes, responsibility for self‐care.

    • Obtain signature(s) for release for transfer of personal medical information and for pediatric care providers to talk with the new adult health care providers

    • Identify new adult care physician

      • If known – request consult (if possible) and transfer records/acquire hard copy of most recent records

      • If unknown – ask teen to inform your office when known to transfer records and request consult

    • Review self‐care issues and how to live a healthy lifestyle with diabetes

      • Medication schedules

      • Self‐monitoring of blood glucose schedule

      • Importance of managing diabetes ABCs (A1C, blood pressure, cholesterol)

      • Meal planning, carb counting, etc.

      • Physical activity routine and its effects on blood glucose

      • Crisis prevention‐management of hypoglycemia (low blood glucose), hyperglycemia (high blood glucose), and sick days

      • Need for wearing/carrying diabetes identification

      • Care of the feet

      • Oral/dental care

      • Need for vision and eye exams

      • Immunizations

      • Staying current with the latest diabetes care practice and technology

      • Preconception care (preparing for a safe pregnancy and healthy baby)

    • Discuss with teen alone: *

      • Sexual activity and safety

      • Screening and prevention of cervical cancer and sexually transmitted infection

      • Risk taking behaviors, e.g. tobacco/alcohol/drug use

    • Consider ongoing visits with current diabetes educator as part of transition

    • Suggest options for a diabetes “refresher” course

 

 

 

Center for Health Services

Northwest Corporate Center

2500 W Higgins Road, Suite 935

900 Building

Hoffman Estates, IL 60169

info@centerforhealthservices.org

 

 Tel: (847)893-9788

 Fax: (847)983-6181

9:00 am and 5:00 pm (CST)

Monday to Friday

 

 

Copyright © 2019. Center for Health Services. All rights reserved