title: The transition from pediatric to adult diabetes care services.
abstract: OBJECTIVE
  A systematic review of the literature was conducted to identify the level of evidence and to describe the evidence on the transition from pediatric to adult healthcare services among youth with diabetes.
  
  
  BACKGROUND
  The transition from pediatric to adult healthcare services is an expectation of youth with diabetes; however, little is known to guide policy and procedures on such transitions.
  
  
  METHODS
  The literature was first searched and screened according to predetermined criterion and then evaluated for level of evidence.
  
  
  RESULTS
  There were 16 mixed qualitative and/or quantitative studies, 23 quantitative studies, and 2 expert opinion articles reviewed. Most of the evidence was from uncontrolled studies. Youth report challenges in making the transition in services. Delay in seeking adult services and poor clinic attendance are issues for these youth. However, it is unclear if these problems are a result of the transition in services. Several promising transition programs have been evaluated and, overall, are found acceptable and useful by youth. In general, evidence suggests that these programs improve glycemic control.
  
  
  CONCLUSIONS
  More research is needed in this challenging area to guide policies and procedures.
  
  
  CONCLUSIONS
  Expert opinion is a guide for policy and procedures at this point in time.
authors.affiliation: School of Nursing, Indiana University, Indianapolis, IN 46202, USA. kathanna@iupui.edu.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Hanna
authors.forename: Jason
authors.initials: J
authors.lastname: Woodward
mesh_terms: D000293:Adolescent; D000328:Adult; D003920:Diabetes Mellitus / Q000628:therapy*; D006302:Health Services Research; D006801:Humans; D060305:Transition to Adult Care