Managing Diabetes Care as Patients Become Adults

For adolescents and young adults, the transition to self-managed healthcare is challenging for anyone—but especially for those living with a serious chronic condition. Research shows that more than 70% of teenagers and young adults with diabetes struggle to maintain blood sugar control during this critical period.

Diabetes affects roughly 1 in 222 people under the age of 22, and despite being one of the most common chronic illnesses in childhood, many young patients feel isolated in their experience. This sense of isolation—combined with the social pressures of adolescence—often contributes to poor glycemic control and the serious long-term complications that follow, including cardiovascular disease, neuropathy, nephropathy, and retinopathy.

At UVA Health Children’s, a transition program helps kids take on and manage their diabetes in small, manageable steps. The result is young adults who feel confident in their ability to manage their diabetes.

When Is It Time to Switch to an Adult Provider?

Santhi Logel, MD, a pediatric endocrinologist with UVA Health Children’s, encourages shared decision-making for this process. “It’s really an individual decision.”

Logel continued, “Some of the things I think about are how well their condition is managed, what life changes they’re going through, and what transition looks like for them.”

College and careers are just two of the major life events that can mean it’s time to start seeing an adult provider.

Transitioning to Managing Care

The transition process begins well before a patient is ready to move to an adult provider. Helping children understand how to manage their condition from an early age builds confidence and a sense of ownership over their care. Diabetes education is one of the many services our pediatric diabetes team provides—from teaching patients how to safely administer injections to helping them feel comfortable discussing psychosocial concerns with their care team.

Fears about gym class, sleepovers, and birthday parties are just a few of the things that are top-of-mind for kids, but not always for the adults in their life.

What Changes with Adulthood?

As adults, these kids will need to manage all of the standard parts of healthcare. That includes scheduling their appointments, requesting refills for their medications, and making sure they’re able to access medical information through a digital patient management system.

But with chronic illness, the intersection of their medical needs and milestones is often more challenging to navigate. While other young adults have likely not had to think through what their health goals and values are, kids with chronic illness need to be prepared to handle these conversations.

For young patients who are newly licensed drivers, for example, the risks of poorly managed blood sugar behind the wheel are real and must be explicitly addressed.

There are also fewer specialist appointments as an adult, which means that concerns may not be caught as quickly. 

What Are Some of the Topics Addressed?

Some of the topics that teenagers review include:

• Safely driving with diabetes
• Healthy meal planning
• Managing medical alerts and ID
• Navigating illness with diabetes
• Contraception and reproductive health planning
• Alcohol and substance use interactions with diabetes

We can also help them learn how to use their smartphones to help manage their illness.

Helping Pediatric Patients Through Transition

Many of our pediatric specialty programs provide help and support through the transition process. For referring providers, that means your one referral helps your patients secure specialty care now and also as they become adults.

To learn more about supporting your patients through this transition—or to make a referral—please visit our provider resources page or contact our pediatric endocrinology team directly.