Positive Transition for Young Adults is the Sweet Spot for PRHC’s Diabetes Transition Clinic

For 21 year old Karly Maloney, managing her diabetes is a way of life. Diagnosed with Type 1 Diabetes in grade 3, Karly has been a patient at the Peterborough Regional Health Centre’s (PRHC) Paediatrics Diabetes program for more than twelve years and has recently moved to the Health Centre’s Young Adult Diabetes Program known as the Diabetes Transition Clinic.

PRHC’s Diabetes Transition clinic is a planned approach to the movement of adolescents and young adults aged 17+ with diabetes from a paediatric diabetes environment to an adult-oriented diabetes clinic.

“According to Diabetes Services at SickKids Hospital in Toronto: five to 10 per cent of all people with diabetes are less than 20 years old – most having Type 1 diabetes,” says Dr. Karolyn Hardy-Brown, Pediatrician at PRHC’s Paediatric Outpatient Clinic and Paediatrics Diabetes Program.  “When it’s time to transition young adults from the pediatric diabetes program to the adult diabetes program that average dropout rate is between 10 to 60 per cent. These statistics are startling when you consider the long-term health risks associated with diabetes.”

Since opening the Diabetes Transition clinic in April 2012, PRHC has helped ease the anxiety associated with changing from one clinical environment to another for more than 20 young adults. The Health Centre’s Paediatric Diabetes team consists of a pediatrician, registered nurse and social worker who work in partnership with the Adult Diabetes healthcare team which includes an endocrinologist, registered nurse and dietitian ensuring a smooth transition in care. “Collectively our two teams are able to transition our younger patients to the adult diabetes environment by preparing them for the changes and ensuring they understand the impacts that diabetes has on their everyday life as they move into adulthood,” added Dr. Hardy-Brown.

For patients like Karly, the Transition Clinic is a huge benefit in ensuring she stays on track. “As a child you don’t really understand everything associated with Diabetes and the long-term health concerns because my parents looked after all that stuff.  But as you grow older you become more aware and begin to realize the impact of not looking after yourself. The realization that Diabetes is a chronic health condition that you need to control can be overwhelming as a young adult, but PRHC’s Transition clinic has helped me manage my condition and have given me the tools and resources for me to take control.”

The clinic’s goal is to prepare young adults to leave the pediatric diabetes clinic by 18 years of age with the skills and knowledge needed to advocate for themselves, maintain their health promotion and self-manage their diabetes while utilizing the adult diabetes health services. “The thought of moving from a small clinical environment where the healthcare team develops a long-lasting relationship with the patient and parents to a large (1000+) environment where patients don’t really yet know their healthcare team and are expected to manage their chronic disease can be frightening when you’re a young adult,” said Dr. Hardy-Brown. “The patient response to the clinic has been overwhelming since opening in April. Our patients appreciate the extra time we’re spending with them on education and making introductions to the adult diabetes healthcare team.”

By investing up front and taking the time to help patients make the move from a paediatric to adult environment, PRHC’s Diabetes Transition clinic is having a lasting positive impact on the overall hospital by:

  • Decreasing emergency room visits and hospital admissions,
  • Decreasing long-term health conditions by ensuring patients’ diabetes are being managed and controlled,
  • Ensuring higher utilization of adult diabetes services and building patients and families relationships with members of the Adult Diabetes Healthcare team,
  • Increasing patients confidence in their ability to self-manage and care for themselves and
  • Reducing the dropout rate associated with the change from one healthcare environment to another.

“I’m no longer on the side lines,” said Maloney. “PRHC’s Diabetes Transition clinic has taught me to take control and ownership of my diabetes. The healthcare team is always positive and supportive.  I never feel overwhelmed by the need to take responsibility and ownership over my chronic condition due to their support and guidance. The team has allowed me to set my own pace and have eased the transition perfectly.”