LAUSR

Background The transition of diabetes care from adolescents to adult management remains a challenging filed due to many social, demographic and economic factors. During the transition phase, strong emphasis is placed on encouraging teens to begin self-care and self-management of their diabetes through guided practice of physical and practical skills needed for this transition. Method A registry system and plan were created to transition adolescent patients with both type 1 and 2 diabetes, starting at the age of 16.5, to adult endocrinology care when the patient turns 18 years old, when graduates from high school or if the female patient becomes pregnant at any time during pediatric endocrinology care. This transition plan includes Identifying and maximizing skills needed for successful self-management of diabetes, identifying barriers to successful transitions, creating a plan of interventions to help and encourage the young adult to continue receiving healthcare, collaborating with the adolescent in locating an adult care endocrinologist who will resume the care, providing teens with discharge of care prescription refills, any supplies needed and school/college instruction packets, and attempt four follow up phone calls to the patient during the transition phase after the patient has been discharged from pediatric care. Results Out of 160 patients (121 type 1 and 39 type 2 diabetes) who started the transition process with at least one visit completed, only 120 patients (75%) completed the process and were formally discharged from clinic. The remaining patients (25%) are still in the transition phase and currently being seen in clinic. We were able to make follow up appointments with adult endocrinologist for the 120 patients transitioned (100%) but only 60 patients documented presence for this follow up (50%). Conclusion The outcome of transition of diabetes care was faced by some obstacles; these can be grouped into: 1-Psychological factors: Adolescents burnt out, depression and adjustment disorders. Lack of Independence and readiness. 2-Factors affecting access to health care: Change of health care insurance, lack of insurance, lack of financial means to pay for visit; and transportation problems. 3- Communication factors: Inability to maintain contact after transition (patients not responding to communication from providers, disconnected phone number). Bridging the gaps in health insurance during this transitional period remains of great importance. Understanding the differences in learning styles between individuals in this transition period will also reflect the readiness for transition.Training health care professionals for this delivery of care is also crucial.