P-36: Bridging the care gap: a qualitative study on the contrasting pediatric and adult approaches and their impact on transition experiences in adolescents and emerging adults with type 1 diabetes mellitus
J Sarma, I Agarwal, T Bhardwaj, P Rawat, R Gupta, P A Praveen, A Goyal, N TandonAbstract
Introduction
The transition from pediatric to adult care is a vulnerable phase for adolescents and emerging adults (AEAs) with type 1 diabetes mellitus (T1DM), often associated with suboptimal glycemic outcomes and disengagement from care. Differences in care models between pediatric and adult services may further complicate this transition. However, perspectives across stakeholders remain unexplored.
Objectives
To examine the differences in care approaches between pediatric and adult providers, and to explore how these differences are experienced by AEAs with T1DM following transition to adult care.
Methods
A qualitative study was conducted using semi-structured, in-depth interviews with 40 AEAs with T1DM (aged 17-22 years) who had recently transitioned to adult care. In addition, key informant interviews were conducted with five paediatricians and seven adult providers (physicians and endocrinologists). The data were analysed using thematic analysis.
Results
Pediatric care was described as family-oriented, with greater provider involvement and support, whereas adult care emphasised patient autonomy and self-reliance. Providers differed in training, expectations and communication styles. AEAs reported increased responsibility and learning in self-management after the transition. However, many described challenges, including shorter consultation times, reduced psychosocial support, and difficulties adapting to less personalised care.
Conclusions
Misalignment between pediatric and adult care approaches may contribute to challenges during transition. Structured transition processes that balance autonomy with continued support, and greater coordination between services, may improve engagement and outcomes for AEAs with T1DM.