The missing link: paediatric to adult transition in diabetes services

Childhood diabetes is a chronic and life-changing condition requiring careful management by clinicians, the child and family. During childhood, care is provided by the paediatric team, which is then transferred to the adult diabetes team during adolescence. This literature review identified five themes in the literature: adolescence as a time of transition; adolescent needs during transition; barriers; facilitators; and models of transition. Key findings suggest that the transition process remains problematic with a gap between paediatric and adult services being identified, including significant differences in clinical practice and culture. Although there is a growing body of knowledge around the reasons behind this phenomenon, research into effective models of transition to address these problems is still lacking. A period of managed transition between the two services has been recommended, with evidence that the nurse has the potential to develop a coordinating role, to assist in bridging the gap between paediatric and adult services.