Paediatric to adult diabetes care: 31 consensus statements across three stages

The International Society for Pediatric and Adolescent Diabetes, the European Association for the Study of Diabetes and the American Diabetes Association formed a joint working group on transition. They reviewed existing recommendations and the evidence systematically, added global surveys of clinicians, people with diabetes and carers, and put lower-graded evidence through a Delphi round. The report, published in Diabetes Care in September 2026, agreed 31 statements spanning the whole transition and three stages: before transfer, the transfer itself, and after it.

Young adulthood is when glycaemic control commonly worsens, clinic attendance falls and unplanned admissions rise. Much of that risk sits in the gap between the last paediatric visit and the first adult one, which no single team owns.

The practical message is that transition is a process with a beginning before the handover and a check after it, not a referral letter. The authors describe the report as a guide to adapt locally, so treat it as a framework for your own clinic's pathway rather than a fixed protocol.

• Start talking about transfer well before the last paediatric appointment, not at it
• Check the young person can manage insulin, sick days and prescriptions without a parent present
• Send a written handover to the adult team and confirm the first adult appointment is booked
• Contact anyone who misses their first adult visit rather than waiting for them to rebook
• Ask about mood, eating, alcohol and contraception, which shape self-management at this age

Why it matters

Lost-to-follow-up young adults are a predictable failure, and this gives clinics a shared framework to design against it.

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