Feeling Ready to Adult? Why Confidence About Managing T1D Doesn't Always Match Blood Sugar Control

Moving from pediatric care to adult healthcare is a major milestone for teenagers with Type 1 diabetes. It involves not just changing doctors, but also taking on greater independence in managing a complex condition. Researchers wanted to understand how prepared adolescents actually feel for this shift—and whether that readiness translates into better diabetes control.

The research included 75 adolescents with T1D aged 17 to 21. Participants completed a 23-item questionnaire designed to measure transition readiness across different areas, such as communication skills, self-management, and navigating the healthcare system. Researchers then compared readiness scores to the teens' HbA1c levels—a standard measure of long-term blood sugar control.

The results revealed a striking disconnect: adolescents' transition readiness scores had no meaningful relationship with their HbA1c levels. In other words, feeling prepared for the transition didn't predict whether someone's diabetes was well-controlled.

The study identified important patterns in which skills adolescents felt most confident about. They scored highest in communication and self-management domains, suggesting many teens feel capable of talking about their diabetes and handling day-to-day care tasks.

However, they scored notably lower in healthcare navigation and transition-specific readiness. This means many adolescents felt less prepared for practical tasks like understanding insurance, scheduling appointments, or advocating for themselves within the adult healthcare system—skills that directly affect care continuity.

The study found that the length of time someone had lived with T1D mattered. Adolescents who had managed diabetes for longer reported higher readiness scores—experience appeared to build confidence. Age and gender, however, showed no significant association with readiness.

Interestingly, technology use—whether someone was using a continuous glucose monitor (CGM) or insulin pump—did not influence transition readiness scores. This suggests that having advanced tools didn't necessarily change how prepared teens felt for the broader shift to adult care.

The gap between feeling ready and having good metabolic control highlights an important reality: transition readiness is complex. It's not simply one measure that predicts success during this critical period. Some adolescents may feel confident in their ability to manage daily diabetes tasks but still need help with healthcare system navigation. Others may have good technical skills but struggle with communication or independent decision-making.

These findings suggest that healthcare teams and families should assess readiness in multiple domains rather than relying on any single indicator. Targeted support in areas where teens feel less confident—particularly around healthcare navigation—might help make transitions smoother and ultimately support better long-term outcomes.

Source: Journal of pediatric endocrinology & metabolism : JPEM. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.