Ready for transition, but ready for outcomes? Discordance between transition readiness and metabolic control in...

Transition from pediatric to adult care is a critical period for adolescents with type 1 diabetes mellitus (T1DM). This study aimed to evaluate transition readiness and its association with glycemic outcomes, and to analyze factors affecting readiness in adolescents with T1DM.

This cross-sectional study included 75 adolescents with T1DM aged 17-21 years. Transition readiness was assessed using a diabetes-adapted 23-item questionnaire based on the Transition Readiness Assessment Questionnaire (TRAQ). Clinical and demographic data were collected retrospectively. Associations between transition readiness scores and HbA_1c levels, categorized using two clinically relevant thresholds, as well as demographic and clinical variables, were analyzed.

The mean transition readiness score was 83.91 ± 14.46. Higher scores were observed in communication and self-management domains, whereas lower scores were noted in healthcare navigation and transition-specific readiness. Transition readiness scores were not associated with HbA_1c levels across different classifications. Diabetes duration was positively correlated with readiness scores (r=0.311, p=0.007), while no significant association was found with age or gender. Technology use (continuous glucose monitoring and insulin pump) was not associated with transition readiness.

Transition readiness in adolescents with T1DM appears to be a multidimensional construct that is not directly reflected by glycemic control. This discrepancy between perceived readiness and clinical outcomes suggests that transition assessments should extend beyond subjective measures and incorporate broader functional domains, including healthcare navigation and real-life independence.