May 07, 2023 Easing the transition to adult diabetes care for teens and their parents

Who:

Dr. Meranda Nakhla, pediatric endocrinologist, Montreal Children’s Hospital, McGill University Health Centre

Research highlights/discoveries:

• Testing an education program to fill a gap previously identified in regard to adolescents transitioning from pediatric to adult diabetes care

Dr. Meranda Nakhla at a glance:

• Recipient of Fonds de recherche du Québec (Quebec Research Fund) Senior Clinical Research Scholar Award (2022)

• Appointed associate professor, Division of Endocrinology, Department of Pediatrics, Montreal Children’s Hospital, McGill University (2020)

• Completed pediatric endocrinology residency training, McGill University (2006)

• Completed her Doctor of Medicine, McMaster University (2000)

How did you get interested in diabetes?

I love the physiology of endocrinology [study of how the endocrine glands and hormones work] and I love working with children. With type 1 diabetes and pediatrics, I have the privilege of working with families over a long period, building relationships, and watching these children grow up.

Why have you focused your research on the transition of adolescents with type 1 diabetes to adult care?

When I was doing my thesis for my master’s degree, I reviewed public health data to look at the health outcomes of adolescents as they transition from pediatric to adult care, as there wasn’t a lot of information readily available on this. The data indicated that adolescents have an increase in diabetes-related hospitalizations during this transition, and it also showed that having a link with a physician or healthcare team seemed to reduce the risk of possible issues.

We know adolescence is a hard time, even without a chronic illness like type 1 diabetes. We also know that when adolescents with type 1 transfer to adult care, they can fall out of regular diabetes care and sometimes don’t see a physician for years—not until there are diabetes-related complications that could have been prevented.

Knowing this, my research team and I developed an intervention to support adolescents during this transition period, and we hope this intervention will have a positive impact in improving health outcomes as the adolescents enter adulthood.

What does the intervention involve?

First, we started a trial of small group visits for adolescents [ages 16–17 years] with type 1 diabetes, where they were provided with education from our healthcare team as well as peer support. Since the teens were driving the conversation, they could focus on what was important to them in managing their diabetes. We are studying how this has affected their transition to adult care by measuring their glycemic [blood sugar] levels, as well as using questionnaires to assess how ready they are for adult care and how confident they are in their skills in managing their type 1 diabetes.

With the support of Diabetes Canada, we started group education sessions for parents of teens with type 1 diabetes, to support parents through their teen’s transition to adulthood. We developed education modules with psychologists to cover topics such as adolescent development, communication, and how parents can prepare for their child’s transition to adult care.

What’s next?

We want to expand this to a large, multi-centre trial to test the education sessions in a larger group of parents and adolescents. If the results are positive in improving diabetes care and quality of life for adolescents with type 1 diabetes, the ultimate goal is to have this intervention integrated into clinical care on a broader scale across the country.

The last word

“Dr. Nakhla’s work with adolescents living with type 1 will enable us to begin building better support systems during the uncertain yet critical transition from childhood to adulthood,” says Laura Syron, CEO and president of Diabetes Canada. “I am excited to see the results of this research study, and the pathway it could reveal for improving health outcomes for youth living with diabetes.”

Did you know?

Teens generally want to try new things and be more independent, and it is important for parents to find a balance between being there to monitor them and encouraging them to take responsibility for their own diabetes management. With patience and a positive attitude, you can help your teen become a responsible and healthy young adult. Diabetes Canada’s D-Camps can also help kids and adolescents with type 1 feel like kids and teach them how to manage their diabetes confidently and successfully. Help us fund research like that of Dr. Nakhla, which has the power to change the lives of teens with type 1 and their parents. #LetsEndDiabetes