Transitions in the care of children and youth with Type 1 diabetes Review

1 ISSN 1758-1907 10.2217/DMT.12.71 © 2012 Future Medicine Ltd Diabetes Manage. (2012) 2(6), 1–xxx Paediatrics, Montreal Children’s Hospital, McGill University Health Centre, 2300 Tupper Street, Montreal, QC H3H 1P3, Canada Department of Paediatrics, University of Toronto, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada *Author for correspondence: Tel.: +1 514 412 4315; [email protected] „ Infants and preschoolers have an increased risk of experiencing severe hypoglycemia, as such glycemic targets are higher in this group compared with older children. „ Schoolaged children may gradually assume more of their daily diabetes management; however, parental supervision and involvement remains essential. „ Early initiation of independent self-management is associated with poorer glycemic control. „ Glycemic control deteriorates during adolescence due to the physiological and psychological changes associated with this stage of development. „ Parental involvement in diabetes management during adolescence is important and is associated with better diabetes outcomes. „ Adolescents with Type 1 diabetes are at an increased risk of having a psychiatric disorder, notably major depressive disorder. „ Preparation for the transition to adult care should begin in early adolescence and involve the whole family unit. „ The transition to adult diabetes care is associated with a deterioration in medical supervision and an increased risk of diabetes-related hospitalizations. „ There is no consensus on the optimal methods to transition patients to adult care. „ The literature on transition care is sparse, in particular there is a paucity of research evaluating different transition care models and their impact on clinical outcomes. „ Strategies such as a young adult clinic, a transition care coordinator and an educational transition program may improve outcomes during the transition process. Pr ac ti ce P oi nt s Transitions in the care of children and youth with Type 1 diabetes Review