Healthcare transition from pediatric to adult medical homes in diabetes mellitus.
OBJECTIVE
To review and exemplify the complexities and challenges in healthcare transition from the pediatric medical home to the adult medical home for patients with type 1 and type 2 diabetes mellitus and to highlight the importance of this topic to adult-focused clinical endocrinologists.


METHODS
We performed a literature search using PubMed and multiple key words. To set the scene for discussions, we also reviewed landmark publications in the general healthcare transition literature over the last several decades; we provide a brief historical perspective at the beginning of our discussions.


RESULTS
Given the critical importance of successful healthcare transition, there is little empirical evidence on key aspects of these transitions. The vast majority of the literature focuses on type 1 diabetes because historically, this form has predominantly affected pediatric patients. However, the increasing incidence and prevalence of pediatric patients with type 2 diabetes makes investigations vital for this patient population too. The Treatment Options for Type 2 Diabetes in Adolescents and Youth study has proved informative in this regard.


CONCLUSIONS
Crossing the chasm between pediatric and adult healthcare remains a remarkably flawed transition process. Healthcare transition should be a planned process of discussing and preparing pediatric patients for the transition and then ensuring continued care as an adult; the greater the collaboration of pediatric and adult endocrinologists in this process, the greater the chance of a successful transition.
Diabetes Center of Excellence, Quintiles.
J Rick
JR
Turner
Diabetes Center of Excellence, University of Florida College of Medicine.
Desmond A
DA
Schatz
Division of Endocrinology, Diabetes and Metabolism, University of Florida College of Medicine.
Kenneth
K
Cusi
Clinical Development, Lexicon Pharmaceuticals, The Woodlands, Texas.
Paul
P
Strumph
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D003920:Diabetes Mellitus / Q000628:therapy*; D006801:Humans; D018802:Patient-Centered Care; D060305:Transition to Adult Care