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The Transition From Pediatric to Adult Diabetes Care Services

Hanna, Kathleen M. PhD, RN; Woodward, Jason MD

doi: 10.1097/NUR.0b013e31828c8372
Feature Article

Purpose: 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.

Description of Project: The literature was first searched and screened according to predetermined criterion and then evaluated for level of evidence.

Outcome: 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.

Implications: Expert opinion is a guide for policy and procedures at this point in time.

Author Affiliations: Professor of Nursing (Dr Hanna), School of Nursing and Assistant Professor of Clinical Medicine and Pediatrics (Dr Woodward), School of Medicine, Indiana University, Indianapolis.

Portions of this article were presented at the American Diabetes Association 72nd Scientific Sessions, June 2012, and for which Dr Hanna received an honorarium. Dr Hanna also received funding from the National Institute of Nursing Research of the National Institutes of Health (RO1 NR009810) during the writing of this article. Dr Woodward reports no conflicts of interest.

Correspondence: Kathleen M. Hanna, PhD, RN, Indiana University School of Nursing, Indianapolis, IN 46202 (

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins