Issue link: https://viewer.e-digitaledition.com/i/425939
IN 2 0 1 1 , T H E A M E R I C A N D i a b e t e s A s s o c i a t io n (ADA) published a posi- tion statement in Diabetes Care highlighting the necessity for codified transition programs to facili- tate diabetes control during patients' graduation from late adolescence to emerging adulthood. In the absence of a transition plan, patients of ten f lounder, unable to seek adult-focused providers, accord- ing to Virginia Peragallo-Dittko, RN, BC-ADM, CDE, FA ADE, Executive Director of the Diabetes and Obesity In st it ute at W i nt h rop -Un iversit y Hospital and Professor of Medicine at SUNY-Stony Brook School of Medicine. "Without a formal transition process, patients are typically lost to follow- up," Peraga llo-Dittko says. " W hen they return to the healthcare system, it's because of acute complications, such as diabetic ketoacidosis, severe hypoglycemia or pregnancy, for which they have received no preconception planning or guidance. So their first encounter with an adult endocrinologist happens in the emergency room." Additionally, those lost to follow up have A1C levels 1.5 percent higher on average than those who maintain scheduled appointments with endo- crinologists, Peragallo-Dittko says. They also struggle with psychosocial ch a l lenges. A s p ed iat r ic pat ient s approach the transition to adult care, they experience significant changes in their personal lives, which can further hinder their ability to take ownership of diabetes self-care. "It's not unusual for variables such as a move from home or change in schedule due to work or school to be concurrent with the transition of diabetes care," says Cindy Bredefeld, DO, CCD, attend- ing physician at Winthrop-University Hospital, Division of Endocrinology, Diabetes and Metabolism and Assistant Professor of Medicine, SUNY-Stony Brook School of Medicine. "It's impor- tant that patients have connected to their adult provider who is supportive of their autonomy and decision-making." Winthrop-University Hospital Bridges Pediatric and Adult Diabetes Care PATIENTS WITH DIABETES, BOTH TYPE 1 AND TYPE 2, NEED REGULAR ENDOCRINOLOGIST FOLLOW-UP LONG AFTER CHILDHOOD ENDS. PROVIDERS AT WINTHROP-UNIVERSITY HOSPITAL HAVE ESTABLISHED A TRANSITION PROGRAM FOR EMERGING ADULTS WITH DIABETES THAT ELIMINATES GAPS IN CARE. By Michael Ferguson Virginia Peragallo-Dittko, RN, BC-ADM, CDE, FAADE, Executive Director of the Diabetes and Obesity Institute at Winthrop-University Hospital, and Professor of Medicine at SUNY-Stony Brook School of Medicine COV ER FE AT UR E 6 | Long Island MD NEWS ■ M D N E W S . CO M