Transition Clinic for 18-Year-Olds
The Diabetes “Transition Clinic” started in 2010 as a partnership between the divisions of Metabolism, Endocrinology & Diabetes and Pediatric Endocrinology. The goal of the clinic is to make the transition to adult care a seamless process for the pediatric patient with diabetes, once they turn 18 years of age.
Some of the patients and their families have been with the U-M Pediatric Endocrinology practice for over 10 years, since they were little children, so the idea of working with a new diabetes team is understandably anxiety-provoking. Further, the shift from child to adult in a medical setting is challenging and often involves considerable stress, as the parents relinquish the responsibility of care to their child. When the parents are involved in the process and understand the next step, they can better support their child during this critical time period.
The Transition Clinic encompasses the pediatric patient’s last visit with the Pediatric Endocrinology staff, which takes place at the MEND Adult Clinic at Domino’s Farms instead of at the Pediatric Endocrinology clinic in C.S. Mott Children's Hospital. The “transition” patients are seen by Christine Sisson, the pediatric nurse practitioner, and a pediatric endocrinologist (Dr. Ram Menon or Dr. Inas Thomas). This staff provides familiarity for patients in the new and unfamiliar adult care setting.
While the adult clinic visit includes many of the same elements as the pediatric visit (history, physical exam, A1C, lab work and blood glucose log review), an added benefit includes a comprehensive, focused educational component on numerous adolescent diabetes-related topics.
Another integral part of the Transition Clinic visit is meeting with a staff representative from MEND. Lynn Lafata, RN, meets with all transitioning patients and introduces the adult care practice, reviews some adult care topics, and answers questions patients may have. Patients and their families have reported that they appreciated meeting an adult diabetes representative and having their questions answered immediately.
Continuity of care is good rationale for providing the Transition Clinic, and the program has received raves from patients and parents alike.
Along with the efforts of the above-mentioned staff, the Transition Clinic was facilitated with the help of Pediatric Endocrinology Administrator Cheng-Yu Chang and Dr. Craig Jaffe, Mary Hubbard, Deb Grzeskowiak, and Ryan Noel from MEND.