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Young adults and Type 1 diabetes: transitioning into adult care

The transition into young adulthood can be an exciting time filled with new beginnings and greater independence. But for young adults with Type 1 diabetes, the transition into this new life stage isn’t quite the same. They often require support from family, friends and their healthcare providers.

Health outcomes for young adults with Type 1 diabetes are poor, because their quality of treatment can decline sharply once they leave pediatric care. For young adults, this disruption in care and loss of guidance in treatment can lead to poor management of their diabetes. In more extreme cases, it can result in hospitalizations or even death.

“Transitioning care from a pediatric program into an adult care program is essential to improving the diabetic health outcomes for this age group,” explains Cheryl Harris-Taylor, social worker, The Centre for Integrated Diabetes Care and Chronic Disease Management at Women’s College Hospital.

“They’re moving from a safe, protective environment, where their parents and multidisciplinary medical team are involved in their care, and suddenly losing this support once they become adults. This high-quality care cannot and should not end once they turn 18.”

New responsibilities

There are several factors that make young adults with Type 1 diabetes suddenly vulnerable. Firstly, managing diabetes can be increasingly difficult when balancing other priorities, such as moving away from home for the first time, or starting a new job or university. With several competing life priorities, young adults tend to feel overwhelmed – and may be unable to handle the pressure of dealing with their health and these new responsibilities at the same time.

“For many young adults with this condition, their diabetes becomes secondary. Watching their diet and monitoring insulin and glucose levels several times a day is a daunting task for any young adult, especially those coming from a program where doctors, nurses, dietitians  and social worker are more involved,” says Harris-Taylor.

This tremendous stress placed upon young adults with Type 1 diabetes can result in chronic neglect of their health. Balancing a part-time job with school and other social priorities means there is less time being spent on crucial aspects of self care. Fast food can become an easier option for meals, leading to a poor diet. With less encouragement from family and healthcare workers, less time may be devoted to monitoring insulin and glucose levels.

Considering costs

Another considerable factor is the financial impact of moving away from home and struggling with medical costs. Needs that were previously taken care of by parents or guardians, such as rent, food and medication, suddenly become the financial responsibility of the individual.

“The combination of these geographic, financial and emotional stress factors can be scary for young adults with Type 1 diabetes to deal with,” adds Harris-Taylor.

Specialized programs

The vulnerability of these patients when they leave pediatric care has led to the development of specialized adult programs dedicated to improving diabetic health outcomes for young adults. Women’s College Hospital is partnering with the Hospital for Sick Children for the ‘Emerging Type 1 Diabetes Adult Program’ to ensure there is a seamless transition once these young adults leave their pediatric programs.

Aside from providing help with monitoring medications regularly, these adult programs also provide support to ease the emotional impact (such as anxiety and depression) of dealing with a chronic condition. Programs also allow participants to interact with others who are in similar situations and who may be experiencing the same emotions.

“These programs provide more than just nurses and doctors to monitor their diabetic condition. They have counsellors such as social workers to help them deal with these negative feelings and to move toward acceptance,” Harris-Taylor adds.

Role of families and friends

Families and friends of these young adults also play a major role in easing the transition from pediatric to adult care. It’s crucial for parents to remain involved by routinely checking how their child is feeling or asking how they can help without being overbearing. Involving friends or roommates of a person with diabetes in their condition can ensure someone else is always checking in.

Through this community of support including doctors, nurses, dietitians, social workers, family and friends, patients are better able to learn how to successfully manage their diabetes.

This information is provided by Women’s College Hospital and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: May 7, 2014

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