Moving to adult services
Adult clinics are shorter, further apart and do not chase you. What changes, what a good handover looks like, and how to get back in if you dropped out.
Moving from children’s diabetes care to adult services is a bigger change than it is usually made to sound. The clinic gets shorter, less frequent and less forgiving of a missed appointment, and the person expected to answer the questions becomes you.
- Appointments are usually shorter and further apart, and nobody chases you the way paediatrics did.
- This is the point where people most often drop out of care, and dropping out is what actually causes harm.
- A good transition is planned: meeting the adult team first, a named contact, and a proper handover.
- Ask about a young adult clinic. Plenty of areas have one and nobody mentions it unless asked.
- If you have already fallen out of the system, you can go back. You will not be told off.
A different building, and a different set of expectations
Paediatric diabetes care is intensive by design. Frequent appointments, a team that knows your family, someone who rings when you do not turn up, and a parent handling most of the logistics. Adult services are built for a much larger number of people with a much wider range of needs, so appointments are typically shorter, further apart, and organised around you taking the initiative.
Some of that is a genuine loss and it is fair to say so. The team that has known you since you were seven is not coming with you, and the new one starts from a letter. But some of it is a gain: you are talked to directly, decisions are yours, and nobody rings your mum to discuss you.
The practical differences to be ready for are that you book and rearrange your own appointments, you contact the team yourself when something is wrong, and your own contact details rather than a parent’s need to be on the record. It is also common for the clinic to be in a different hospital from the one you have always gone to.
Why this is the point care most often stops
The years around this move are when people are most likely to disappear from diabetes services, and it is worth being blunt about why that matters: the risk is not the appointment being missed, it is the years afterwards with no eye screening, no foot checks and nobody to ask. Almost everything the annual checks exist to catch early is catchable early, and only if someone is looking.
The reasons people drop out are ordinary rather than dramatic. The move coincides with leaving school, starting work or university, moving away from home, and a general phase of life where a hospital appointment on a Tuesday afternoon is the least appealing thing available. Add a clinic that no longer chases you, and disappearing takes no decision at all.
Which is why the most useful thing on this page is the fact that going back is easy. If you stopped attending, whether last year or five years ago, ringing the clinic or your GP is enough to restart it. Teams are used to this and are pleased when someone comes back, not annoyed. Nobody is going to lecture you, and if anyone did, that would be worth complaining about rather than accepting.
What to ask for, and what to have ready
A good transition happens over time rather than on a birthday. What that looks like in practice: meeting the adult team, or at least visiting the clinic, before the first real appointment; a proper handover rather than just a letter; a named person to contact; and clarity about what happens between appointments. Ask about a young adult or transition clinic, because many areas run one for roughly the late teens to mid twenties and it is far closer to what you are used to.
Have your own information ready, because the new team starts without the history your old one carried in their heads. That means knowing the names of your insulins and devices, having your current settings written down rather than only in a parent’s phone, and knowing roughly what your recent results have been. It also means your own phone number and email on the record.
For parents, the useful version is handing over tasks well before the clinic changes: booking, ordering prescriptions, ringing the nurse, doing the talking at appointments. A handover that has been rehearsed for two years goes very differently from one that happens the week the clinic changes, and the point is not to step back all at once but to stop being the only person who knows things.
What makes the move easier or harder
Doing several changes at once is the hardest version, and it is also the most common: transition, leaving home and starting somewhere new often land in the same year. Whether a transition clinic exists makes a real difference and is worth asking about directly. And how much you already handle yourself is the thing most within reach before the move happens.
How this goes
Examples, not instructions or doses.
One missed clinic in a busy term, then a year of nothing because paediatrics chased and adult services do not. Not a decision, just a gap.
Booking, ordering and doing the talking taken over two years before the clinic changed. The move itself was administrative rather than a cliff.
Ringing after several years away and being booked in without a lecture. Teams are used to this and would much rather you came back.