Abstract

Transition in Type 1 diabetes mellitus from a tertiary pediatric center: what are we doing before they walk out the door?

Author(s): Mary White, Michele A O\'Connell & Fergus J Cameron

Aims: Planned transition to adult services in the form of a formal written document should be standard practice in the management of young adults with chronic disease. The aim of this audit was to provide details on the process of transition in youth with Type 1 diabetes mellitus at the Royal Children’s Hospital, Melbourne, Austrailia.

Methods: This was a retrospective review of patients with Type 1 diabetes mellitus who transitioned from the Royal Children’s Hospital between June 2009 and June 2011.

Results: A total of 180 youth were transitioned from pediatric services at the Royal Children’s Hospital to adult hospital services during this time. The mean (± standard deviation) age of transfer was 18.4 ± 0.7 years, and the majority of youth were transitioned to centers within the Melbourne metropolitan area. Pertinent clinical details were often missing from transition referral letters, which were sent in only 82.8% (149/180) of cases. Transition occurred in an apparently unplanned way or without physician input for 30.6% (55/180) of youth in this cohort.

Discussion: A high standard of referral documentation should be routine for all transitioning youth, to serve as an introduction to our adult colleagues and to provide a comprehensive medical summary. Emphasis should be placed on the inclusion of accurate contact details to allow for optimal follow-up.