Transition of young adults with type 1 diabetes mellitus from a pediatric to adult diabetes clinic – problems, challenges and recommendations

ABSTRACT: Type 1 diabetes is a chronic disease associated with the risk of acute and chronic complications. The patients with type 1 diabetes require constant monitoring in a diabetes outpatient clinic, regardless of their age, and the cessation of diabetes care may result in deterioration of metabolic control and earlier development of chronic complications. When the children grow up and reach 18 years of age, they must transfer from the custody of the pediatric outpatient clinic to the care of adult diabetes center. This is a very important time in the life of a young patient. When the transition is well planned, it can help young adults to live with diabetes independently. The paper presents the differences between pediatric and adult diabetes care and factors influencing diabetes control during transition process. In the article we discuss programs implemented in other countries to help young people with diabetes during transition process. Moreover the paper also demonstrates the recommendations of some scientific societies for the optimal organization of the transition to prevent a deterioration of metabolic control of diabetes. ABBREVIATIONS: DMT1- type 1 diabetes mellitus, HbA1c - glycosylated hemoglobin, PTD - Polish Diabetes Association, ADA - America Diabetes Association, SEARCH - SEARCH for Diabetes in Youth study, NICE - National Institute for Excellence.