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Improved transition in care in diabetes

From child care to adult care

Young people aged 15 to 25 have the worst diabetes regulation of all age groups. The way of life and the developmental task of becoming of independence in this stage of life, are often in conflict with living with diabetes mellitus type 1 (DM1).

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Adolescence is a difficult stage, not only for the young people themselves, but also for their parents and healthcare professionals. They will have to hand over the control of the treatment to the young person and ensure a smooth transition to internal medicine. Several international studies have shown that a significant number of youth drop out of the specialized diabetes care services for a certain period of time.

In recent years, a great amount of knowledge has become available on the risks of poorly organised transition in care for DM1, and about the principles of good transitional care. The existing practice in the Netherlands falls short to this.

The NDF Zorgstandaard (Standard for Care) describes the standard for good diabetes care, also paying attention to what young people experience when they transfer from child care to adult care. It is emphasised that special attention is needed in this transition phase, and structural alignment between child care and adult care has to take place, including a period of shared care. Still, it is unclear how many diabetes care teams in the Netherlands have actually organised such structural alignment and cooperation between child care and adult care. It is also unknown what experiences youth and adults have with the transition care and which form of transitional care leads to the best results. 

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