FORGE Ahead

Growing up with type 1 diabetes requires flexibility and support. While the day to day tasks of checking blood sugars, counting carbohydrates and taking insulin don’t change much over time, how involved teens and young adults are in other diabetes-related tasks certainly does. There is no timetable with the age at which a teen or young adult should be doing all of his/her diabetes management. In fact, we recommend that teens share diabetes management with their parent(s)/guardian all the way through adolescence because it is a lot to do all by yourself. And, as the teen or young adult shows more motivation to take care of him/herself, parent(s) can slowly step back.

Eventually, you will also shift your diabetes care over to an adult practice. Research shows that unless this transition from a pediatric to an adult practice is thoughtful and planned, young adults can stop going for regular diabetes check-ups, and diabetes management can decline, leading to:

  1. increases in HbA1c levels; 
  2. more frequent hospitalizations; 
  3. psychosocial problems; and 
  4. higher risks for long-term medical complications.

FORGE Ahead outlines key principles which guide a series of educational goals and activities for teens >13 years old regarding the medical, nutritional and psychosocial aspects of diabetes care that aim to prepare an adolescent to gradually assume full responsibility for his/her diabetes care over the course of several years. Once the young adult is armed with a solid foundation of knowledge and behavioral practices to manage diabetes with the pediatric team at the Yale Children’s Diabetes Program, he/she will then be seen in the Yale Bridge Clinic.

We hope that by thinking about it early with you and your parents, we can help minimize the anxiety and uncertainty that can commonly accompany this significant change in your diabetes care. Here are some ideas that we believe can help you FORGE Ahead, and prepare for moving on to the adult-phase of your diabetes care.