Labrador-Grenfell Health Region
The patient population in the Labrador-Grenfell region is small, with about 7 pediatric type 1 diabetes patients in their care and less than 1 patient transferring from pediatric to adult care per year. The pediatric type 1 diabetes team consists of a pediatrician, a nurse educator, and a dietician. Transition preparation starts at age 16 and patients are transferred at age 17. To prepare for transition, patients are encouraged to take more responsibility for their diabetes management and to attend appointments without their parents or guardian. They also provide patients with information about going to university, drug and alcohol use, sexual education, and other relevant topics. At the time of transition, if the patient is staying in the Labrador-Grenfell health region, the care team and clinic location remains the same with only the physician changing from a pediatrician to a family physician (Table 2, Quote 5). The clinic structure also remains the same with appointments being automatically booked for patients every 3 months, reducing loss to follow-up for those young adult patients who remain in the region. If they are moving to another region, the Labrador-Grenfell team assists the patient in finding a new physician. For all patients transitioning, the pediatrician sends a referral letter to their new adult physician. Table 1 provides a summary of the programs in the four regions.