572-P: Transition Survey of Adult Diabetes Education Centers in Ontario, Canada

Young adults with type 1 diabetes face many physiological and psychological issues in adolescence, which negatively impact glycemic control and long-term health outcomes. Dedicated transition programs facilitating the transition from pediatric to adult care have shown favourable outcomes with regards to clinic follow-up, glycemic control, and diabetes-related complications. In Ontario, Canada, it is unclear how transition programs are implemented given the lack of formal processes. Our study surveyed adult diabetes education centers in Ontario with the goal of identifying current availability and characteristics of various transitional programs, while exploring perspectives on transitional practices, clinical experiences, and barriers. There were 53 (20.2%) diabetes education centers that participated in our survey. Majority respondents were females (n=50, 94%), between age 40-50 years (n=21, 40%), identifying as a nurse or dietitian (n=35, 66%), working in a community setting (n=43, 81%). Only 25% (n=13) of respondents identified a transition program in their center, however 30.2% (n=16) provided care to both pediatric and adult patients. Where no transition programs were available, the main reason was low perceived importance and/or need (n=22, 41.5%). A lack of guidelines on what program to adopt in addition to lack of personnel and financial resources were the main barriers reported. Where transition programs were available they included education materials (n=9, 17%) and a joint clinic between pediatric and adult care (n=5, 9.4%). Only 5.7% (n=3) respondents identified a designated transitional coordinator. Almost a third of respondents (n=15, 28.3%) noted that the most common referral method was from the emergency room or following a hospitalization, rather than from a pediatric-based program (n=9, 17%). Despite a greater awareness of transition issues over the last decade, the use of structured transition programs requires further improvement across the province of Ontario, Canada.