Skip to main content
SpringerLink
Log in

Adult Care: Practical Considerations for Patients with Endocrine Conditions Transitioning from Pediatric to Adult Care

  • Chapter
  • First Online:
Book cover Transitioning from Pediatric to Adult Care in Endocrinology

  • 395 Accesses

Abstract

Young adults with chronic endocrine diseases are a vulnerable patient population who undergo unique developmental and life changes, which require specific expertise and resources for care. Inherent differences exist in pediatric and adult-oriented care systems, which may affect the quality and level of care that young adults receive. Pediatric care approaches the young adult as a part of the larger family support system, while adult care approaches the young adult in isolation with links to other supports. Adult providers may not be trained to specifically care for young adults or have clinic resources to address pressing developmental issues. In contrast, pediatricians may not be specifically trained in diagnosing or managing comorbidities or complications of endocrine diseases that often present in adulthood. Overall, issues related to differences between pediatric and adult care can be improved by integrated efforts aimed at several key targets. This chapter reviews the optimal adult care approach to young adults with endocrine diseases and offers choice resources and practical strategies, which can change practices to accommodate this vulnerable population.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Arnett JJ. Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469–80. https://doi.org/10.1037/0003-066X.55.5.469.

    Article  CAS  PubMed  Google Scholar 

  2. Peters A, Laffel LMB, American Diabetes Association Transitions Working Group. Diabetes care for emerging adults: recommendations for transition from pediatric to adult diabetes care systems. A position statement of the American Diabetes Association, with representation by the American College of Osteopathic Family Physicians, the A. Diabetes Care. 2011;34:2477–85.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Chiang JL, Kirkman MS, Laffel LMB, Peters AL. Type 1 diabetes through the life span: a position statement of the American Diabetes Association. Diabetes Care. 2014;37(7):2034–54. https://doi.org/10.2337/dc14-1140.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Standards of Medical Care in Diabetes-2016. Diabetes Care 2016;39(January):86–93. https://doi.org/10.2337/dc16-S014.

  5. Sanghani NB, Parchwani DN, Palandurkar KM, Shah AM, Dhanani JV. Impact of lifestyle modification on glycemic control in patients with type 2 diabetes mellitus. Indian J Endocrinol Metab. 2013;17(6):1030–9. https://doi.org/10.4103/2230-8210.122618.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hargreaves DS, Greaves F, Levay C, et al. Comparison of health care experience and access between young and older adults in 11 high-income countries. J Adolesc Health. 2015;57(4):413–20. https://doi.org/10.1016/j.jadohealth.2015.05.015.

    Article  PubMed  Google Scholar 

  7. Stollon NB, Paine CW, Lucas MS, et al. Transitioning adolescents and young adults with sickle cell disease from pediatric to adult health care: provider perspectives. J Pediatr Hematol Oncol. 2015;37(8):577–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Agarwal S, Garvey KC, Raymond JK Schutta M. Perspectives on care for young adults with type 1 diabetes transitioning from pediatric to adult health systems: a national survey of pediatric endocrinologists. Pediatr Diabetes, 2016;18(7):524–531.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Garvey KC, Telo GH, Needleman JS, Forbes P, Finklestein JA, Laffel L. Health care transition in young adults with type 1 diabetes: perspectives of adult endocrinologists in the U.S. Diabetes Care. 2016;39(2):190–7.

    CAS  PubMed  Google Scholar 

  10. Arden-Close E, McGrath N. Health behaviour change interventions for couples: a systematic review. Br J Health Psychol. 2017;22(2):215–37. https://doi.org/10.1111/bjhp.12227.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Mayberry LS, Osborn CY. Family support, medication adherence, and glycemic control among adults with type 2 diabetes. Diabetes Care. 2012;35(6):1239–45. https://doi.org/10.2337/dc11-2103.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gleeson H, Davis J, Jones J, O’Shea E, Clayton PE. The challenge of delivering endocrine care and successful transition to adult services in adolescents with congenital adrenal hyperplasia: experience in a single centre over 18 years. Clin Endocrinol. 2013;78(1):23–8. https://doi.org/10.1111/cen.12053.

    Article  Google Scholar 

  13. Hokken-Koelega A, van der Lely A-J, Hauffa B, et al. Bridging the gap: metabolic and endocrine care of patients during transition. Endocr Connect. 2016;5(6):R44–54. https://doi.org/10.1530/EC-16-0028.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bryden KS, Peveler RC, Stein A, et al. Clinical and psychological course of diabetes from adolescence to young adulthood. Diabetes Care. 2001;24(9):1536–40. https://doi.org/10.2337/diacare.24.9.1536.

    Article  CAS  PubMed  Google Scholar 

  15. Butwicka A, Frisén L, Almqvist C, Zethelius B, Lichtenstein P. Risks of psychiatric disorders and suicide attempts in children and adolescents with type 1 diabetes: a population-based cohort study. Diabetes Care. 2015;38:dc140262. https://doi.org/10.2337/dc14-0262.

    Article  Google Scholar 

  16. Rassart J, Luyckx K, Bijttebier P, Berg C, Moons P, Weets I. Psychosocial functioning and glycemic control in emerging adults with type 1 diabetes: a 5 year follow-up study. Health Psychol 2015;34(11):1–8.

    Article  PubMed  Google Scholar 

  17. Johnson B, Elliott J, Scott A, Heller S, Eiser C. Medical and psychological outcomes for young adults with type 1 diabetes: no improvement despite recent advances in diabetes care. Diabet Med. 2014;31(2):227–31. https://doi.org/10.1111/dme.12305.

    Article  CAS  PubMed  Google Scholar 

  18. Malik FS, Hall M, Mangione-Smith R, et al. Patient characteristics associated with differences in admission frequency for diabetic ketoacidosis in United States children’s hospitals. J Pediatr. 2016;171:104–10. https://doi.org/10.1016/j.jpeds.2015.12.015.

    Article  PubMed  Google Scholar 

  19. Rodwell L, Romaniuk H, Nilsen W, Carlin JB, Lee KJ, Patton GC. Adolescent mental health and behavioural predictors of being NEET: a prospective study of young adults not in employment, education, or training. Psychol Med. 2017:1–11. https://doi.org/10.1017/S0033291717002434.

    Article  PubMed  Google Scholar 

  20. American Academy of Pediatrics and American College of Physicians, Transitions Clinical Report Authoring Group AA of FP. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2011;128(1):182–200. https://doi.org/10.1542/peds.2011-0969.

    Article  Google Scholar 

  21. Vance SR Jr, Halpern-Felsher BL, Rosenthal S. Health care providers’ comfort with and barriers to care of transgender youth. J Adolesc Health. 2015;56(2):251–3.

    Article  PubMed  Google Scholar 

  22. Program Requirements for GME in Pediatrics. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/320_pediatrics_2017-07-01.pdf. Accessed 21 May 2018.

  23. Program Requirements for GME in Internal Medicine. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/140_internal_medicine_2017-07-01.pdf. Accessed 21 May 2018.

  24. Vigersky RA, Fish L, Hogan P, et al. The clinical endocrinology workforce: current status and future projections of supply and demand. J Clin Endocrinol Metab. 2014;99(9):3112–21. https://doi.org/10.1210/jc.2014-2257.

    Article  CAS  PubMed  Google Scholar 

  25. Lyons SK, Helgeson VS, Witchel SF, Becker DJ, Korytkowski M. Physicians’ self-perceptions of care for emerging adults with type 1 diabetes. Endocr Pract. 2015;21(8):903–9.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Jackson GL, Powers BJ, Chatterjee R, Bettger JP, Kemper AR, Hasselblad V, Dolor RJ, Irvine RJ, Heidenfelder BL, Kendrick AS, Gray R, Williams J. Improving patient care. The patient centered medical home. A systematic review. Ann Intern Med. 2013;158(3):169–78.

    Article  PubMed  Google Scholar 

  27. Schultz S, Abercrombie S, Crownover B, Hoekzema G, Krug N, Maxwell L, Mazzone M, Mitchell K, Shaffer T, Tuggy M. Accountable care organizations: an opportunity for synergy. Ann Fam Med. 2013;11(3):283–4.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Gill M, Chhabra H, Shah M, Zhu C, Lando H, Caldarella F. Association between provider specialty and healthcare costs and glycemic control for patients with diabetes. J Med Econ. 2018;21:704–8; Epub ahead:1–5.

    Article  PubMed  Google Scholar 

  29. Kordonouri O, Klingensmith G, Knip M, Holl RW, Aanstoot HJ, Menon PS CMIS for P and AD. ISPAD clinical practice consensus guidelines 2014. Other complications and diabetes-associated conditions in children and adolescents. Pediatr Diabetes. 2014;15(S20):270–8.

    Article  CAS  PubMed  Google Scholar 

  30. Flechtner-Mors M, Wiegand S, Gellhaus I, Siefken-Kaletka H, Widhalm K, Reinehr T, Roost HP, Leipold G, Hoffmeister U, Holl R. Screening for co-morbidity in 65,397 obese pediatric patients from Germany, Austria and Switzerland: adherence to guidelines improved from the year 2000 to 2010. Obes Facts. 2013;6(4):360–8.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Katz M, Zijing G, Laffel L. Management of hypertension and high low-density lipoprotein in pediatric type 1 diabetes. J Pediatr. 2018;197:140–146.e12. Epub Ahead.

    Article  CAS  PubMed  Google Scholar 

  32. Hilliard ME, Perlus JG, Clark LM, et al. Perspectives from before and after the pediatric to adult care transition: a mixed-methods study in type 1 diabetes. Diabetes Care. 2014;37(2):346–54. https://doi.org/10.2337/dc13-1346.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Lyons SK, Libman IM, Sperling MA. Diabetes in the adolescent: transitional issues. J Clin Endocrinol Metab. 2013;98(12):4639–45. https://doi.org/10.1210/jc.2013-2890.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Garvey KC, Foster NC, Agarwal S, DiMeglio LA, Anderson BJ, Corathers SD, Desimone ME, Libman IM, Lyons SK, Peters AL, Raymond JK, Laffel L. Health care transition preparation and experiences in a U.S. national sample of young adults with type 1 diabetes. Diabetes Care 2017;40(3):317–324.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Got transition. www.gottransition.org [Internet]. [cited 2018 May 16].

  36. Garvey KC, Wolpert HA, Laffel LM, Rhodes ET, Wolfsdorf JI, Finkelstein JA. Health care transition in young adults with type 1 diabetes: barriers to timely establishment of adult diabetes care. Endocr Pract. 2013;19(6):1–22. https://doi.org/10.4158/ep13109.or.

    Article  Google Scholar 

  37. Hynes L, Byrne M, Casey D, Dinneen SF, O’Hara MC. It makes a difference, coming here’: a qualitative exploration of clinic attendance among young adults with type 1 diabetes. Br J Health Psychol. 2015;20(4):842–58. https://doi.org/10.1111/bjhp.12145.

    Article  PubMed  Google Scholar 

  38. Paine CW, Stollon NB, Lucas MS, et al. Barriers and facilitators to successful transition from pediatric to adult inflammatory bowel disease care from the perspectives of providers. Inflamm Bowel Dis. 2014;20(11):2083–91. https://doi.org/10.1097/MIB.0000000000000136.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Valenzuela JM, Seid M, Waitzfelder B, et al. Prevalence of and disparities in barriers to care experienced by youth with type 1 diabetes. J Pediatr. 2014;164(6):1369–1375.e1. https://doi.org/10.1016/j.jpeds.2014.01.035.

    Article  PubMed  PubMed Central  Google Scholar 

  40. McManus MA, Pollack LR, Cooley WC, et al. Current status of transition preparation among youth with special needs in the United States. Pediatrics. 2013;131(6):1090–7. https://doi.org/10.1542/peds.2012-3050.

    Article  PubMed  Google Scholar 

  41. Van Walleghem N, MacDonald CA, Dean HJ. Evaluation of a systems navigator model for transition from pediatric to adult care for young adults with type 1 diabetes. Diabetes Care. 2008;31(8):1529–30. https://doi.org/10.2337/dc07-2247.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Holmes-Walker DJ, Llewellyn AC, Farrell K. A transition care programme which improves diabetes control and reduces hospital admission rates in young adults with type 1 diabetes aged 15–25 years. Diabet Med. 2007;24(7):764–9.

    Article  CAS  PubMed  Google Scholar 

  43. Sequeira PA, Pyatak EA, Weigensberg MJ, et al. Let’s empower and prepare (LEAP): evaluation of a structured transition program for young adults with type 1 diabetes. Diabetes Care. 2015;38(8):1412–9. https://doi.org/10.2337/dc14-2577.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Agarwal S, Raymond JK, Cardillo SC, Schutta MH, Miller VA, Long J. An adult healthcare-based pediatric to adult transition program for emerging adults with type 1 diabetes. Diabetes Educ. 2017;43(1):87–96.

    Article  PubMed  Google Scholar 

  45. CDC. National vital statistics reports. 2016;65(5). https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_05.pdf.

  46. Gilbody S, Richards D, Brealey S, Hewitt C. Screening for depression in medical settings with the patient health questionnaire (PHQ): a diagnostic meta-analysis. J Gen Intern Med. 2007;22(11):1596–602. https://doi.org/10.1007/s11606-007-0333-y.

    Article  PubMed  PubMed Central  Google Scholar 

  47. d’Emden H, McDermott B, D’Silva N, et al. Psychosocial screening and management of young people aged 18–25 years with diabetes. Intern Med J. 2017;47(4):415–23. https://doi.org/10.1111/imj.13375.

    Article  PubMed  Google Scholar 

  48. Dabelea D, Stafford JM, Mayer-Davis EJ, et al. Association of type 1 diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young adulthood. JAMA. 2017;317(8):825–35. https://doi.org/10.1001/JAMA.2017.0686.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Young-Hyman D, de Groot M, Hill-Briggs F, Gonzalez JS, Hood K, Peyrot M. Psychosocial care for people with diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39(12):2126–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Agarwal S, Raymond JK, Schutta MH, Cardillo S, Miller VA, Long JA. An adult health care–based pediatric to adult transition program for emerging adults with type 1 diabetes. Diabets Educ. 2016;43(1):87–96.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrinology, Albert Einstein College of Medicine, Bronx, NY, USA

    Shivani Agarwal

Authors
  1. Shivani Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shivani Agarwal .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Sarah K. Lyons

  2. Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Marisa E. Hilliard

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Agarwal, S. (2019). Adult Care: Practical Considerations for Patients with Endocrine Conditions Transitioning from Pediatric to Adult Care. In: Lyons, S., Hilliard, M. (eds) Transitioning from Pediatric to Adult Care in Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-030-05045-0_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-05045-0_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-05044-3

  • Online ISBN: 978-3-030-05045-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation