November 20, 2012


McMaster University pediatricians look to bridge the care gap for young adults


Hamilton, Ont. November 20, 2012Brianne Brady was nine when she was diagnosed with Type 1 diabetes and as a child she had an established relationship with a team of health-care professionals. But when she became an adult, she had to restart from square one.


There’s a dangerous gap for children with the chronic illness that can be fatal, say pediatricians at the Michael G. DeGroote School of Medicine at McMaster University, and they’re actively working to change that transition.


Brady, a Guelph Ontario resident, found it challenging to navigate the health care system as an adult. At 19, her transition into adult care with an entirely different team left her feeling removed from the system with far less appointment flexibility and less frequent access to the doctor.


“It was like starting from scratch,” she said. “There is a lack of communication between the pediatric and the adult clinic, which makes it hard for the new doctor to fully understand the patient.”


With research demonstrating the transition from pediatric to adult diabetes care is a high-risk period for many youths, McMaster University researchers are making it a top priority for the Department of Pediatrics to identify the gaps in care.


Dr. Christina Grant, associate professor of pediatrics and an adolescent medicine physician, said the loss of parents’ supervision of diabetes care and the challenges of work or school means up to 35 per cent of youths don’t show up for their diabetic medical appointments which leads to increased hospitalization and mortality rates.


“These young people literally fall off the cliff,” Grant said.


Once youths are transferred to an adult diabetes clinic, there are different expectations as the focus is on adults taking responsibility for their own care, Grant said. This poses a problem as these young adult brains are still developing and they remain unprepared, she added.


“We know that some of our patients will have more diabetes-related hospitalizations after transition to adult care,” said Dr. Karen McAssey, a pediatric endocrinologist and associate professor of pediatrics. “This demands that we carefully consider the before and after events during transition.”


Brady said she has managed to keep on top of her medical appointments, but she has peers who have fallen behind. One of her motivations to keep her scheduled appointments is her government-funded insulin pump, which requires proof of medical visits.


“I know lots of people who have lost their insulin pumps because they don’t keep their blood sugar on target or they don’t go to their appointments,” she said.


Earlier this month Hamilton pediatricians and health care professionals had a session, sponsored by the Sir Frederick Banting Legacy Foundation, with University of Manitoba pediatric endocrinologist Heather Dean about Manitoba’s Maestro Project, a transition program for young adults with diabetes. Then health professionals, patients and parents gathered to brainstorm on addressing the gaps in transition care. Priorities identified included increased communication between pediatric and adult health-care teams and employing youth to assist and mentor other youths.


An award, sponsored by the Sir Frederick Banting Legacy Foundation, will also go to a resident in pediatrics/internal medicine to gain experience at McMaster in transition care.






For further information and to arrange interviews, please contact:


Veronica McGuire

Media Relations

Faculty of Health Sciences

McMaster University

905-525-9140, ext. 22169