Most children being treated for type 1 diabetes transition to adult services when they finish secondary school. However, despite being a very vulnerable time for these young people, there are still no national guidelines governing the move from paediatric to adult services, doctors have warned.

The incidence of type 1 diabetes is increasing worldwide, particularly in children, and currently in Ireland, there are 19 hospitals which provide care for these young people.

According to Limerick-based doctors writing in the Irish Medical Journal, ‘transition to adult care occurs during a vulnerable time for those with chronic childhood diseases because of the psychological and physiological changes of adolescence'.

The transition to adult services is a complicated process that should address a range of different needs, including medical, psychosocial and educational.

"Optimum transition requires sufficient resources to address these areas. Currently in Ireland, national guidelines or models of transition care for children with type 1 diabetes are lacking," the doctors said.

They looked at all 19 units that currently provide care to children with type 1 diabetes in this country. These units currently care for almost 2,800 children and the transition to adult services typically takes place between the ages of 16 and 18 years, when the children have completed their secondary education.

The doctors noted that the transition period ‘is increasingly recognised as an important part of paediatrics and adult medicine, but one which requires resource investment'.

"When transition is poorly organised, the results include poor attendance at adult clinics and increased risks of short-term and long-term complications. The respondents in our study cited lack of resources and lack of national guidelines as barriers to optimising transition in their own units," they noted.

They also found that many units could not provide any data on adolescents following their transition.

"There appears to be disconnect between paediatrics and adult services, which could be improved with more resources and with a national database," they suggested.

They found that some of the 19 units had a ‘transition unit' for teenagers and some offered access to transition information sessions or a psychologist, but there was ‘little national consistency'.

The doctors said that there is now a need for a ‘collaborative national framework on type 1 diabetes transition'. Such a move would help healthcare professionals who are in the process of setting up, or are revising, their own transition clinics for young people.