Transitional care in Ireland leaves young adults with type 1 diabetes at sea

Research from Trinity College Dublin highlights a number of factors that cause young adults with type 1 diabetes to find they’re not well prepared for a move to adult clinics.
The transition from a paediatric clinic to an adult clinic can be something of a large step change. At child clinic, patients become used to seeing a familiar health team and, by the end of their care at the child clinic, doctors often have a very good knowledge of their patient.
In addition, youngsters have had time to build rapport and trust with their health team, which can be very important for young adults going through a series of life changes whilst managing a notoriously tricky long term condition, requiring management through blood tests and insulin administration through each day.
Upon reaching adulthood, however, that knowledge, trust and rapport is lost as those with Type 1 diabetes are transferred to an adult clinic with a new set of doctors, often a new location and frequently involves a significantly different way in which care is delivered.
Young adults can often feel let down by the transitio, citing not being given adequate forewarning of when or how the transition will take place and a lack of rapport building during initial adult clinic visits.
Professor Imelda Coyne notes how teenagers can become disengaged as a result of transition: “They stop managing their illness because they don’t feel linked in with the adult service.”
It’s not just the adult clinics that can make patients feel at sea. In some cases, problems can be made worse by paediatric clinics not ensuring that teenagers approaching adulthood are prepared well enough to take enough responsibility for their diabetes once they reach the adult clinic. Professor Coyne adds: “Some of them had not developed the skills in self-caring and self-advocacy; they felt a little bit lost.”