title: Health Care Transition Preparation and Experiences in a U.S. National Sample of Young Adults With Type 1 Diabetes.
abstract: Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. We developed a survey to evaluate transition experiences in two groups of young adults with type 1 diabetes, before (PEDS) and after (ADULT) transition to adult care.
  
  
  
  We fielded an electronic survey to young adults (18 to <30 years) at 60 T1D Exchange Clinic Registry centers.
  
  
  
  Surveys were completed by 602 young adults, 303 in the PEDS group (60% female, age 20 ± 2 years) and 299 in the ADULT group (62% female, age 24 ± 3 years). In the PEDS group, mean anticipated transition age was 22 ± 2 years; 64% remained in pediatric care because of emotional attachment to the provider. The ADULT group transitioned at age 19 ± 2 years, mainly after pediatric provider recommendation. More than 80% of respondents reported receiving counseling on type 1 diabetes self-management and screening tests from pediatric providers, but less than half (43% PEDS and 33% ADULT) reported discussing reproductive health. In the PEDS group, half had discussed transfer with pediatric providers. Of the ADULT participants, 63% received an adult provider referral, and 66% felt mostly/completely prepared to transition. ADULT participants with fewer pretransition pediatric visits or who felt unprepared for transition had increased odds of gaps >6 months between pediatric and adult care. Receipt of transition preparation counseling was not associated with self-reported hemoglobin A1c<7.0% in either group.
  
  
  
  These results support the need for intensive efforts to integrate transition preparation counseling and care coordination into pediatric type 1 diabetes care.
authors.affiliation: Boston Children's Hospital, Boston, MA.
authors.forename: Katharine C
authors.initials: KC
authors.lastname: Garvey
authors.affiliation: Jaeb Center for Health Research, Tampa, FL t1dstats@jaeb.org.
authors.forename: Nicole C
authors.initials: NC
authors.lastname: Foster
authors.affiliation: University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
authors.forename: Shivani
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Linda A
authors.initials: LA
authors.lastname: DiMeglio
authors.affiliation: Baylor College of Medicine, Houston, TX.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Anderson
authors.affiliation: Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Corathers
authors.affiliation: State University of New York Upstate Medical University, Syracuse, NY.
authors.forename: Marisa E
authors.initials: ME
authors.lastname: Desimone
authors.affiliation: Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.
authors.forename: Ingrid M
authors.initials: IM
authors.lastname: Libman
authors.affiliation: Baylor College of Medicine, Houston, TX.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Lyons
authors.affiliation: Keck School of Medicine of the University of Southern California, Los Angeles, CA.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Peters
authors.affiliation: Barbara Davis Center for Diabetes, Aurora, CO.
authors.forename: Jennifer K
authors.identifier: 0000-0003-1866-4932
authors.initials: JK
authors.lastname: Raymond
authors.affiliation: Joslin Diabetes Center, Boston, MA.
authors.forename: Lori M
authors.initials: LM
authors.lastname: Laffel
mesh_terms: D000293:Adolescent; D000328:Adult; D003376:Counseling; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D012648:Self Care; D060305:Transition to Adult Care; D014481:United States; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin