This CME Activity has expired and is no longer available for credit.
Handling the Hand-Off: Transitioning from Pediatric to Adult Diabetes Care
Time to Complete
September 28, 2012
January 31, 2013
Recent studies predict that the number of individuals being diagnosed with type 1 diabetes annually will increase to 160,000 in 2020. Of greatest concern is the increasing incidence in younger children, concurrent with an epidemic of childhood obesity and growing numbers of children and adolescents being diagnosed with type 2 diabetes. This increase in the prevalence of diabetes during the childhood years means increasing numbers of young adults having to make the transition from pediatric to adult diabetes specialty care. If not handled systematically, this difficult transition can promote the development of poor self-care habits, including risky behaviors such as insulin restriction for weight control. The high rate of medical dropout seen during this transition corresponds with increased rates of acute and chronic complications seen in emerging adults. Therefore, the successful transition from pediatric to adult diabetes care settings is key to maintaining optimal health in young adults (ages 18–22).
After taking part in this educational activity, participants should be better able to:
Describe a systematic process to help prepare young adults (ages 18–30) to successfully transition to adult diabetes specialty practice
Identify the challenges to optimal diabetes management and glycemic control during the process of transition, overlapping the period of adolescence and emerging adulthood
Discuss emotional issues and high-risk behaviors to be addressed during the transition process
Identify the roles of primary care providers, healthcare teams, and families of young adults throughout the transition process
Apply a stepwise process in individual practice settings to facilitate responsible diabetes management and self-care
Faculty Barbara J. Anderson, is on the DAWN Youth Advisory Board for Novo Nordisk Inc.
Kathleen A. Bratt, has no relevant financial relationships.
Dr. Lori M. Laffel, is on the speakers bureau for Johnson & Johnson, Novo Nordisk Inc., and sanofi-aventis U.S. LLC; is a consultant for Bayer and Bristol-Myers Squibb Company; is a consultant and on the speakers bureau for Abbott Diabetes Care, Inc., Eli Lilly and Company, The Menarini Group, and Roche Diagnostics; and is a consultant for and receives research/grant support from Medtronic MiniMed, Inc.
Sue McLaughlin, is on the advisory board for Intuity Medical, Inc.
Planning Committee Dr. Richard S. Beaser, is a consultant for CeQur Ltd.
Julie Brown, has no relevant financial relationships.
Carolé Mensing, is a consultant for Healthy Interactions, Inc., and Novo Nordisk Inc.
Cindy Pasquarello, has no relevant financial relationships.
Alissa R. Segal, was on the advisory board for Eli Lilly and Company in 2009.
CME Advisory Committee Dr. Enrique Caballero, is a consultant and on the speakers bureau and scientific advisory board for Amylin Pharmaceuticals, Inc., AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Daiichi Sankyo, Inc., and Eli Lilly and Company.
Dr. Jerry Cavallerano, has no relevant financial relationships.
Dr. A. Patrick Egan, has no relevant financial relationships.
Anne E. Goebel-Fabbri, has no relevant financial relationships.
Dr. Osama Hamdy, is on the speakers bureau for Amylin Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Merck & Co., Inc., Novo Nordisk Inc., and Takeda Pharmaceuticals North America, Inc.
Karen J. Kuc, has no relevant financial relationships.
James E. Neighbours, has no relevant financial relationships.
Dr. Euyiche Okeke, has no relevant financial relationships.
Dr. Kenneth J. Snow, has no relevant financial relationships.
Jonathan Scoble, has no relevant financial relationships.
Dr. Robert C. Stanton, has no relevant financial relationships.
Dr. Howard A. Wolpert, is a consultant for Abbott Diabetes Care, Insulet Corporation, Novo Nordisk, Inc. and Becton, Dickinson and Company.
Unapproved Product Use This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Joslin Diabetes Center do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Joslin Diabetes Center. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer The information presented in this activity is not intended to replace sound medical judgment or clinical decision-making, and the recommendations provided should be adapted to particular patient care situations, where more or less stringent interventions are necessary.
Barbara J. Anderson, PhD Professor of Pediatrics Baylor College of Medicine Associate Head of the Psychology Section Texas Children's Hospital Houston, TX
Kathleen A. Bratt, PNP, CDE Program Moderator Pediatric Nurse Practitioner Joslin Diabetes Center Affiliate at Upstate Medical University Syracuse, NY
Lori Laffel, MD, MPH Associate Professor of Pediatrics Harvard Medical School Chief, Pediatric, Adolescent and Young Adult Section Investigator, Genetics and Epidemiology Section Joslin Diabetes Center Boston, MA
Sue McLaughlin, RD, CDE, CPT Adjunct Instructor and RD, CDE Staff Member School of Allied Health Professionals The Nebraska Medical Center Omaha, NE
Planning Committee: Richard S. Beaser, MD* Associate Clinical Professor of Medicine Harvard Medical School Medical Executive Director Professional Education Joslin Diabetes Center Boston, MA
Julie Brown* Director Professional Education Joslin Diabetes Center Boston, MA
Carolé Mensing, RN, MA, CDE, FAADE Manager for Clinical and Education Programs Joslin Diabetes Center Boston, MA Past President, Health Care and Education, American Diabetes Association
Cindy Pasquarello, BSN, RN, CDE Nurse Manager Pediatric, Adolescent, and Young Adult Unit Joslin Clinic Boston, MA
Alissa R. Segal, PharmD, PhC, RPh, CDE Associate Professor of Pharmacy Practice Massachusetts College of Pharmacy & Health Sciences Clinical Pharmacist Joslin Diabetes Center Boston, MA
*Also on the CME Advisory Committee
CME Advisory Committee: Enrique Caballero, MD Director, Medical Affairs Professional Education Director, Latino Diabetes Initiative Joslin Diabetes Center Boston, MA
Jerry Cavallerano, OD, PhD Optometrist Beetham Eye Institute Joslin Diabetes Center Boston, MA
A. Patrick Egan, MD Family Practice Internal Medicine Specialist Dorchester House Multi-Service Center Boston, MA
Ann E. Goebel-Fabbri, PhD Instructor in Psychiatry Harvard Medical School Psychologist Behavioral and Mental Health Unit Joslin Diabetes Center Boston, MA
Osama Hamdy, MD, PhD, FACE Assistant Professor of Medicine Harvard Medical School Medical Director, Obesity Clinical Program Joslin Diabetes Center Boston, MA
Karen J. Kuc Assistant Director, Grants and Projects Professional Education Joslin Diabetes Center Boston, MA
James E. Neighbours, MEd Associate Director, Education Design Professional Education Joslin Diabetes Center Boston, MA
Eyiuche Okeke, MD Instructor in Medicine Harvard Medical School Outcomes Investigator Department of Professional Education Staff Endocrinologist Joslin Diabetes Center Boston, MA
Jonathan Scoble Grants Manager Professional Education Joslin Diabetes Center Boston, MA
Kenneth J. Snow, MD, MBA Assistant Professor of Clinical Medicine Harvard Medical School Senior Physician, Adult Diabetes Section Joslin Diabetes Center Boston, MA
Robert C. Stanton, MD Associate Professor of Medicine Harvard Medical School Chief of Nephrology Joslin Diabetes Center Boston, MA
Howard Wolpert, MD Assistant Professor of Medicine Harvard Medical School Director, Insulin Pump Program Senior Physician Joslin Diabetes Center Boston, MA
This program is sponsored by the Joslin Diabetes Center.
This activity is supported by an educational grant from Eli Lilly and Company.
Target audience include primary care physicians, physician assistants, nurses, nurse practitioners, diabetes nurse educators, dieticians, pharmacists, and other allied healthcare professionals treating young patients with type 1 diabetes.
AMA PRA Category 1 Credit(s)TM
The Joslin Diabetes Center, Boston, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Joslin Diabetes Center designates this educational activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
1. Read the learning objectives, accreditation information, and faculty disclosures at the beginning of the activity. 2. Read the text and view the slides. 3. Complete the posttest and evaluation. 4. Physicians who receive a grade of 70% or better on the posttest and who complete the evaluation will receive immediate CME credit. 5. All other participants who receive a grade of 70% or better on the posttest and who complete the evaluation will receive a certificate of participation.