TAKING CHARGE, WHAT IS TRANSITION
Your diabetes, your routine, built up step by step over the years.
Growing up with diabetes means gaining the knowledge, skills, and support you need to manage it independently. It might seem overwhelming, but transition happens slowly over years, you won’t be on your own all of a sudden.
Building skills for independence
Transition usually begins around age 12 or 13, but the switch from a pediatric endocrinologist to an adult one usually happens from age 18 into the early twenties. During these years, your medical team will guide you and practice with you the skills you need to manage diabetes on your own.
📚 Knowledge basics
- Understand what diabetes is and how insulin works
- Know how to manage diabetes in different situations
- Know when to seek emergency support
- Try practicing with “what if” games at dinner or in the car with a parent
🥗 Nutrition
- Estimate food portions and carb intake
- Calculate carbs and insulin doses, and correction doses (more in Chapter 11: Nutrition & Carb Counting)
- Read food labels with confidence
- Make smart choices when eating out
🎉 Social situations
- Learn to manage diabetes outside your regular daily routine, during camps, vacations, trips, when going out
- Reduce the risk of hypo- and hyperglycemia, keep an emergency kit ready
- Take responsibility by checking blood sugar outside your usual routine (e.g., before driving)
- Know what to think about in relationships and around sex (more in Chapter 23: Relationships & Sexual Health)
- Stay safe at parties and around alcohol (more in Chapter 27: Alcohol, Smoking, Vaping & Substance Use)
⚽ Sports and exercise
- Inform coaches about your diabetes
- Let them know what to do in case of hypoglycemia
🏥 Medical appointments and supplies
- Know how to contact your medical team
- Schedule and reschedule your own medical appointments
- Set reminders for appointments
- Order and pick up medication and insulin pump supplies
- Prepare questions before check-ups
💉 Daily management
- Calculate insulin doses based on carb intake
- Calculate correction doses when needed (more in Chapter 13: Managing Highs & Lows)
- Handle hypo- and hyperglycemia (blood sugar too low or too high)
- Change your infusion sets and pump on your own
- Manage a sick day on your own, including checking ketones and knowing when to call
How medical transition should work
What should be in place before you transition to adult care.
Some, but not all, care teams have care navigators or ambassadors who help with the transition to adult care. They are more common in larger cities and bigger hospitals. If yours does not have one, all is not lost. Just make sure the following is set up, so the transition is smooth.
- A written clinical summary from your pediatrician or endocrinologist, whoever treats you for your diabetes
- A written transition plan, also from your pediatrician or endocrinologist
- Direct communication between your new adult team and your old pediatric team. Ideally a phone call or a meeting, not just an email
When it feels like a lot
Transition is a big change, and it is not uncommon for it to feel heavy sometimes.
If you are transitioning, or have just transitioned out of your pediatric team, and you notice a rising HbA1c or more highs and lows than usual, it can be a sign that something else is going on. Feeling overwhelmed during this time is common, with a chronic condition or without one. It matters that you find support, so please do not delay and do not be ashamed. Most people do not talk about it, but this affects far more people than you would think.
If you are not sure where to start, findahelpline.com can connect you to free, confidential support in your country. In the U.S., call or text 988 in an emergency.