Moving to adult diabetes services : University College London Hospitals NHS Foundation Trust

You can stay with the children and young people’s diabetes team (also known as paediatrics) until you turn 19.

It is a good idea to start thinking about adult services several years before this to make sure you are prepared and choose the right service for you.

Here are some important things that you need to know and should think about over the next few years:

Turning 18

Once you turn 18 years old, we will need to communicate with you about your diabetes. If your parents contact us, we are unable to share any information with them unless we have your permission
We will help ensure you have access to MyCare and MyChart app so you can see all your records and appointments electronically. You can give your parents proxy access if you want to.

Topping up your diabetes expertise before you move to adult clinics

Is there anything about your diabetes management that you would like to know more about? We can arrange appointments to help increase your knowledge in different areas for example:

Carbohydrate counting
Understanding glucose/pump downloads
Travelling with Type 1 diabetes
Managing high and low glucose levels
Managing exercise
Drinking alcohol safely
Managing diabetes at work
Travelling with diabetes

Choosing an adult team

Our team can help find the right adult diabetes team for you. Most of our patients move to another hospital once they are 19.

UCLH adult diabetes service is available to all in North Central London (Camden, Islington, Haringey, Barnet and Enfield). If you live out of area there are other options for care in London hospitals or locally to your home address.

Some things to consider

Location: How far do you want to travel? You might be studying or working. Think about how much time you will be able to be away from work.

Cost: Think about how much it costs to travel to your adult team. Remember parking costs.

Experiences: You will be invited to a transition talk at UCLH where you can listen to experiences of those who have moved to an adult service.

Other conditions: if you have another condition for which you are under a hospital team, you might consider moving diabetes care to the same hospital. This means that the different teams will find it easier to communicate with each other and have access to the medical records.

Do your research: look at the hospital webpage for information about the diabetes service. Some services have a young adult clinic with a dedicated nurse who can offer increased support when you transfer to them.

You can discuss any of the above in your medical appointment in the lead up to transition

What’s different in an adult diabetes clinic?

You may find some differences in adult clinics such as:

less frequent appointments. If you feel you need extra support in between medical appointments, you can contact the adult team who will book you in. This is something you can discuss with your adult team at your first appointment.
HbA1c is checked less frequently in adult clinics. Some will use finger prick HbA1c testing and some will ask you to have a blood test before your appointment. This is something to factor into your time.
Fewer professionals in one room.
You may not see the same person at each appointment.
Adult services offer structured education programmes which can be a great way to update knowledge and meet others living with type 1 diabetes e.g. DAFNE (Dose Adjustment for Normal Eating).

Equipment and Supplies

If you are using an insulin pump and/or glucose sensor most adult centres will continue to provide these. Some adult services may not be able to provide the same insulin pumps/sensors and will offer an alternative. Therefore, it is a good idea to check what is available before moving to an adult service.
At your final appointment with us we will ask you to order 3 months’ supply of pump consumables. Once you have your first appointment with the adult team, they will set up your new account for pump supplies.
Your 4-year warranty period remains the same i.e. the warranty will expire 4 years after you started on your pump regardless of whether you are in adults or paediatric service.
You will continue to order supplies in the same way.

GP

If you are planning to go to university, we suggest keeping your GP nearest to your permanent address. For most people this is their home address.
Once you turn 18 you will need to have a medical exemption certificate as evidence of your entitlement to free prescriptions. To apply, you will need to get a form from your GP.
You should learn how to order and collect repeat prescriptions from your GP. The NHS app is a helpful way to order any repeat prescriptions, which can be sent to a named pharmacy of your choice.