Table 1—

Recommendations for facilitating the transition process from pediatric to adult diabetes care provider

Pediatric providersAdult providers
Universal recommendations
Facilitate family and social supports for daily diabetes care tasks.Facilitate family and social supports for daily diabetes care tasks.
Assess for disordered eating.Assess for disordered eating.
Assess for alcohol and/or drug history.Assess for alcohol and/or drug history.
Assess for history of mental health services.Assess for history of mental health services.
Develop “transition” clinic days, where pediatric and adult providers meet patients and their families at the same time.Develop “transition” clinic days, where pediatric and adult providers meet patients and their families at the same time.
Develop ongoing educational programs for providers regarding transition issues.Develop ongoing educational programs for providers regarding transition issues.
Discipline-specific recommendations
Hire a “transitions coordinator” to facilitate transition. Develop telephone and e-mail contact with young adults to facilitate transition plans. Develop a Web site or newsletter that provides information regarding access to services and funding.Screen for early microvascular complications.
Collaborate with patients and their families to develop an individualized written transition plan ∼2 years prior to the transition date. The written plan should include:Obtain/develop teaching materials that are developmentally appropriate for adolescents and young adults.
    1) an assessment of the patient's knowledge and skills
    2) information regarding adult care providers and how to access those services
    3) information regarding access to funding/insurance coverage after age 18 years.