How a Structured Transition Program Could Help Young People Move From Teen to Adult Diabetes Care

Around age 18, young people with Type 1 diabetes typically move from pediatric clinics—where doctors specialize in treating children—to adult endocrinology practices. This shift sounds straightforward, but many teens and young adults report feeling unprepared. Without the right support, patients may miss appointments, struggle to manage their own care, or experience gaps in treatment.

These disruptions can have real consequences: missed clinic visits, medication mistakes, and worsening blood sugar control. Mental health can suffer too. Yet despite decades of research showing this is a problem, many healthcare systems still offer little formal help to bridge this gap.

The COCCOS project developed a new transition program by listening to what young people with chronic conditions actually need. The program isn't a one-time conversation; it's four structured clinic visits spread across 13 to 16 months. Each visit focuses on building practical skills, encouraging independence in self-care, and planning for continuity of treatment.

The program is being tested in two university hospitals in Belgium, with young people aged 17–18 who have Type 1 diabetes, asthma, or obesity. Half receive the new structured program (intervention group), while half receive standard transition care (control group). This design allows researchers to directly compare outcomes.

The study's main goal is to see whether the COCCOS program improves how ready young people feel for the transition. Readiness will be measured using a validated tool called the Transition Readiness Assessment Questionnaire.

But readiness is only part of the story. Researchers are also tracking medication adherence (whether teens actually take their insulin and other medicines as prescribed), mental health, quality of life, and empowerment—the sense of being in control of one's own care. Data will be collected at the start, at the time of transfer to adult care, and again four months later.

A key question is cost-effectiveness: Does the extra structure and support save money and improve health enough to justify its cost? Researchers will analyze this from a healthcare system perspective.

Numbers tell only part of the story. The COCCOS team is also examining how well the program actually works in real clinics—whether staff deliver it as planned, whether young people find it acceptable, and what barriers or helpful factors emerge in each setting. They'll do this through observations, surveys, and interviews.

This mixed-methods approach is important because a program that looks good on paper might not fit smoothly into every hospital or work for every patient. Understanding why the program succeeds or struggles will help other healthcare systems decide whether and how to adopt it.

The COCCOS study is registered on ClinicalTrials.gov and is expected to yield results in the coming years. If the structured transition program proves effective and cost-effective, it could become a model for helping young people with Type 1 diabetes—and other chronic conditions—navigate one of the most disruptive changes in their healthcare journey.

For now, if you're a parent or young person facing this transition, this research highlights why asking your healthcare team about transition preparation is important. Not every clinic offers a structured program yet, but the evidence is growing that deliberate, supported transitions lead to better long-term outcomes.

Source: PloS one. 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.