Publication Date


Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Kathleen Rindahl

Second Advisor

Therese Hinz

Third Advisor

Lana Frederickson


Transition, Adolescent, Young adult, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus


The purpose of this study was to identify the optimal age to target transition to adult care education for adolescent and young adults (AYA) with Type 1 and Type 2 Diabetes Mellitus (DM) as they transition from pediatric endocrinology providers to adult DM providers. A secondary purpose of this study was to identify if there was a relationship between attendance rate, age, gender, years diagnosed with DM, ethnicity, insurance type, Type of DM, and current county of residence with control of diabetes, measured by glycosylated hemoglobin (HgbA1c). A quantitative study through chart audits was conducted at Valley Children’s Healthcare, VCH, pediatric endocrinology practice, in Madera, California. Patients with the diagnosis of Type 1 or Type 2 DM born been 1997-1999, aged eighteen to twenty-one years old seen for at least one provider visit in 2017, were audited. The data was analyzed for Chi-Square Test of Independence to identify if attendance rate to appointments between 2014-2017 has a relationship to patients year of birth and to determine if the average HgbA1c in 2017 has a relationship to patient demographics.

The research instrument was an excel work sheet used to analyze collected data. Data was collected by manual chart audits and analyzed with SPSS soft wear.

Current literature lacks conclusive data of when transition to adult care skills should be taught to AYAs with DM and how it impacts diabetic control in adolescents and young adults with DM. In addition, unique factors that have not been previously studied in the population seen at VCH are that eighty percent of patients have Medi-Cal California Children Services insurance indicating the majority of the population lives below the federal poverty level; the practice is a regional center for over twelve counties in California; and sixty-five percent of children in this region are from Hispanic origin.


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