Type 1 Diabetes Transition Program at a Children’s Hospital—Lessons Learned and Future Directions

Abstract

Background: Transitioning a child with type 1 diabetes (T1DM) poses many challenges. Structured programs decrease loss to follow-up and hospitalization rates. We created a transition program, modeled after the Sweet transition program (Queensland, Australia) and monitored the outcomes. Methods: The program was implemented in April 2015. Steps included: Assessing T1DM knowledge at age 12, education based on need/age, providing an adult provider list, sending providers a clinical summary and maintaining a referral registry. The program was revised in October 2016, now included follow-up by a coordinator and a patient survey evaluating the program. Results: There was increased attendance to education sessions. Transition to adult care within 6 months also improved. No one was lost to follow-up. We received useful feedback from patients about the program. Lessons learned: 1. The ADA guidelines need to be customized based on available resources. 2. Starting at age 12 helps improve transition. 3. A transition registry and coordinator are important. Future directions: 1. Provide subjective assessments for patients to gauge their T1DM knowledge. 2. Collaborate with adult providers via combined clinic. Table 1: Comparison of Program OutcomesApril 2015-16October 2016-17Total No. of Type 1 Patients910875High School and Beyond Education22 (8%)71 (30%)Transfer of Care Education 16 (8%)44 (29%)Referred Patients Seen within 6 months59%80%Referred Patients Seen >6 months17%20%Referred Patients Lost to Follow Up24%0% Disclosure H. Cornwell: None. S. Yigit: None. R. Purushothaman: None.