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 Outcomes
| April 2015-16 | October 2016-17 | |
| Total No. of Type 1 Patients | 910 | 875 |
| High School and Beyond Education | 22 (8%) | 71 (30%) |
| Transfer of Care Education | 16 (8%) | 44 (29%) |
| Referred Patients Seen within 6 months | 59% | 80% |
| Referred Patients Seen >6 months | 17% | 20% |
| Referred Patients Lost to Follow Up | 24% | 0% |
| April 2015-16 | October 2016-17 | |
| Total No. of Type 1 Patients | 910 | 875 |
| High School and Beyond Education | 22 (8%) | 71 (30%) |
| Transfer of Care Education | 16 (8%) | 44 (29%) |
| Referred Patients Seen within 6 months | 59% | 80% |
| Referred Patients Seen >6 months | 17% | 20% |
| Referred Patients Lost to Follow Up | 24% | 0% |
H. Cornwell: None. S. Yigit: None. R. Purushothaman: None.
