The Transition of Youth With Diabetes From Pediatric to Adult Diabetes Care Services: A Consensus Report of the Joint Working Group of the International Society for Pediatric and Adolescent Diabetes (ISPAD), the European Association for the Study of Diabetes (EASD), and the American Diabetes Association (ADA)

Abstract

Young adulthood is a period of significant and unique physiological, psychological, sexual, and social upheaval. Related challenges can have an impact on effective diabetes self-management, with high rates of unplanned health care use recorded for many, and consequent increases in the risks of premature morbidity and mortality. Health care professionals need guidance in delivering transition support for adolescents and young adults with diabetes. This would help to facilitate the formulation and implementation of local policies and procedures, enabling guidelines to be translated into practice and improving transition of care readiness. This led the International Society for Pediatric and Adolescent Diabetes (ISPAD), the European Association for the Study of Diabetes (EASD), and the American Diabetes Association (ADA) to convene a working group to produce a consensus report on the transition from pediatric to adult diabetes health care services. The ACCORD and AGREE II recommendations for the development of consensus reports and clinical guidelines, respectively, were followed. Existing diabetes-specific recommendations on the transition of care, published statements, a prior position paper, general recommendations, and online toolkits were initially identified and reviewed. Current evidence was then systematically reviewed, supplemented with primary data on the perceptions and experiences of health care professionals and of people with diabetes and their caregivers from global surveys. Evidence with a grading of A or B was automatically included in the consensus statements; evidence with a C or E grading was subjected to a Delphi survey for validation. Consensus was obtained for 31 statements on the full transition of care continuum and the three unique stages of pre-transfer, transfer, and post-transfer. This consensus report should be viewed as a guide and adjusted to local settings.