As if entering adulthood wasn't tough enough, teens with diabetes face an extra challenge just about the time they're graduating from high school and reaching adulthood: they're forced to transition from close, intimate pediatric care settings to the hard, "get 'em in, get 'em out" world of adult healthcare, where so much depends on jobs, health insurance and self-motivation.
Historically pretty much ignored by the medical establishment, "emerging adults" with diabetes, ranging from 18 to 30 years old, were the focus of several research studies at the American Diabetes Association's Scientific Sessions recently.
This is incredibly important, because that point of "leaving the nest" can be a make or break time for how PWDs carry on their D-management throughout their lives. It's no wonder that statistically this group has the hardest time managing their diabetes — and not just because of all the sex, drugs and rock n' roll, either! Some of the blame falls on the healthcare system.
In one study presented at the ADA Conference, some young adults had access to continuous care while another group had a gap in care. Those with a gap in care were three times more likely to be admitted to the emergency room and had an average A1C that was 2% higher! That's a huge difference!
There's also an issue of when a teen should transition. Another study looked at high school students during their senior year, and then again a year later. There were three groups: teens who started and stayed in pediatric care, teens who transitioned from pediatric to adult care, and teens who were already in adult care. Those who stayed in pediatric diabetes care did the best overall, with the best self-care and the lowest A1C, and those who were already in adult care had the worst A1C. Researchers concluded that transitioning teens out of pediatric care can actually be detrimental to the teen's health. This isn't to say teens should not start taking more responsibility for their own diabetes, but it does indicate that a better transitional process is needed and possibly more supervision could come from the parents.
One researcher looking into making this process better is Dr. Anne Peters, an adult endocrinologist who is Director of the Diabetes Program at the University of Southern California (USC), head of the nation's largest outreach program for community-based diabetes prevention and treatment in Los Angeles, and author of the best-selling book Conquering Diabetes.
Dr. Peters presented a talk at the Scientific Sessions on best practices and challenges of working with emerging adults. She also took some time to speak with us about the work she is doing, the differences between pediatric and adult diabetes care practices, and what parents and teens can do to prepare for the big leap: