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Handling the Hand-off: Transitioning from Pediatric to Adult Diabetes Care

Activity Description

CME Release Date: 12/13/2010
CME Expiration Date: 1/31/2013

This Internet enduring material activity was developed from presentations made at the live symposium titled
Handling the Hand-off: Transitioning from Pediatric to Adult Diabetes Care that took place on August 6, 2010,
in San Antonio, TX, as part of the AADE's Annual Meeting.

This activity is supported through educational grants provided by Eli Lilly and Company.

Statement of Need

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).

Target Audience

This certified CME Internet activity enduring material has been developed for primary care providers, nurse practitioners, and both clinical and office staff who treat patients with diabetes. There is no fee to participate in this activity.

Learning Objectives

Participants will be provided with clinically relevant, evidence-based information. Upon completion of this activity, participants should be able to:

  • Describe 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 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 and Disclosures

Barbara J. Anderson, PhD
Professor of Pediatrics
Baylor College of Medicine
Associate Head of the Psychology Section
Texas Children's Hospital
Houston, TX

Disclosure: Barbara J. Anderson is on the DAWN Youth Advisory Board for Novo Nordisk Inc.

Kathleen A. Bratt, PNP, CDE
Program Moderator
Pediatric Nurse Practitioner
Joslin Diabetes Center Affiliate at Upstate Medical University
Syracuse, NY

Disclosure: Kathleen A. Bratt has no relevant financial relationships.

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

Disclosure: 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, RD, CDE, CPT
Adjunct Instructor and RD, CDE Staff Member
School of Allied Health Professionals
The Nebraska Medical Center
Omaha, NE

Disclosure: Sue McLaughlin is on the advisory board for Intuity Medical, Inc.

Planning Committee:

Richard S. Beaser, MD*
Associate Clinical Professor of Medicine
Harvard Medical School
Medical Executive Director
Professional Education
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Richard S. Beaser is a consultant for CeQur Ltd.

Julie Brown*
Director
Professional Education
Joslin Diabetes Center
Boston, MA

Disclosure: Julie Brown has no relevant financial relationships.

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

Disclosure: Carolé Mensing is a consultant for Healthy Interactions, Inc., and Novo Nordisk Inc.

Cindy Pasquarello, BSN, RN, CDE
Nurse Manager
Pediatric, Adolescent, and Young Adult Unit
Joslin Clinic
Boston, MA

Disclosure: Cindy Pasquarello has no relevant financial relationships.

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

Disclosure: Alissa R. Segal was on the advisory board for Eli Lilly and Company in 2009.

*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

Disclosure: 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.

Jerry Cavallerano, OD, PhD
Optometrist
Beetham Eye Institute
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Jerry Cavallerano has no relevant financial relationships.

A. Patrick Egan, MD
Family Practice
Internal Medicine Specialist
Dorchester House Multi-Service Center
Boston, MA

Disclosure: Dr. A. Patrick Egan has no relevant financial relationships.

Ann E. Goebel-Fabbri, PhD
Instructor in Psychiatry
Harvard Medical School
Psychologist
Behavioral and Mental Health Unit
Joslin Diabetes Center
Boston, MA

Disclosure: Anne E. Goebel-Fabbri has no relevant financial relationships.

Osama Hamdy, MD, PhD, FACE
Assistant Professor of Medicine
Harvard Medical School
Medical Director, Obesity Clinical Program
Joslin Diabetes Center
Boston, MA

Disclosure: 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
Assistant Director, Grants and Projects
Professional Education
Joslin Diabetes Center
Boston, MA

Disclosure: Karen J. Kuc has no relevant financial relationships.

James E. Neighbours, MEd
Associate Director, Education Design
Professional Education
Joslin Diabetes Center
Boston, MA

Disclosure: James E. Neighbours has no relevant financial relationships.

Eyiuche Okeke, MD
Instructor in Medicine
Harvard Medical School
Outcomes Investigator
Department of Professional Education
Staff Endocrinologist
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Euyiche Okeke has no relevant financial relationships.

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

Disclosure: Dr. Kenneth J. Snow has no relevant financial relationships.

Disclosure: Jonathan Scoble has no relevant financial relationships.

Robert C. Stanton, MD
Associate Professor of Medicine
Harvard Medical School
Chief of Nephrology
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Robert C. Stanton has no relevant financial relationships.

Howard Wolpert, MD
Assistant Professor of Medicine
Harvard Medical School
Director, Insulin Pump Program
Senior Physician
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Howard A. Wolpert is a consultant for Abbott Diabetes Care, Insulet Corporation, Novo Nordisk, Inc. and Becton, Dickinson and Company.

Accreditation and Designation of Credit

The Joslin Diabetes Center, Boston, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Joslin Diabetes Center designates this educational activity for a maximum of 1.00 AMA PRA Category 1 Credits.TM Physicians should only claim credit commensurate with the extent of their participation in the activity.

This CME activity was planned and produced in accordance with ACCME Essentials.

Participants not eligible for continuing medical education credit will receive a certificate of participation.

Computer Requirements

To participate in this activity, your computer will need the following hardware and software:

Credit Instructions

  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.

Questions About This Activity

For questions regarding the content of this activity, contact the accredited provider for this CME activity: cme@joslin.harvard.edu

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Page last updated: November 23, 2014