TRANSITIONING TO ADULT CARE As adolescents transition into adulthood, changes in finances, insurance, living situation, occupation, and education produce a potential gap in care for those with T2DM. In the year prior to the transition to adult care, the clinician should set clear expectations for the patient’s responsibilities when he or she assumes self-care.26
In addition, the clinician should provide the transitioning patient and family with an up-to-date summary of the patient’s health status, medications, and dates and results of the most recent examinations and screenings. If the patient has been under the care of a pediatric clinician, referral to a trusted adult health care provider may be helpful.
Transition planning checklists, resources, and information forms that can be provided to the new health care team are available from the National Diabetes Education Program (a partner of the NIH and CDC) at http://ndep.nih.gov/transitions.
CONCLUSION Primary care clinicians will likely see a growing number of pediatric patients with T2DM. Consultation with or referral to pediatric medical subspecialists, ongoing comanagement with experts in the evolving pediatric T2DM field, and strong partnerships with parents and caregivers, will ensure that optimal care of the pediatric patient’s lifetime health needs is initiated and maintained.