Background: Type 1 Diabetes (T1D) is a chronic autoimmune disease requiring lifelong vigilance and usually diagnosed in childhood. As children transition from primary to secondary school, they face increasing demands for disease autonomy amid reduced caregiver and school-based supports. There is very little research thus far into the effect of this school transition on T1D management.The aim of this study is to identify challenges in care during this transition period by directly liaising with children and their caregivers, using the strengths and weaknesses described to develop age-appropriate autonomy supports co-produced with those who it aims to serve.Method:This mixed methods prospective study looked at two cohorts of children, pre and post primary school transition and their parents/guardians at the University of Limerick paediatric department. Qualitative questionnaires were used and chart data pertaining to comorbidities, insulin regime, age, duration of diagnosis and socio-economic grouping was obtained. Thirty-six children/caregivers were recruited.Results: Anxiety around increased disease autonomy required in secondary school and gaps in school supports post-transition have been identified as major issues for T1D children and families. Decreased school supports and lack of disease awareness by school staff were identified by over 90% of those interviewed. Parents and children have identified strengths within the UHL framework of care and highlighted the need to support this transition period.Conclusion: The transition between primary and secondary school is a vulnerable time for young people with T1D and requires increased disease autonomy at a time of much developmental and psychological change. By analysing this transition period, teams and families with T1D, can respond to and meet the needs of the young person as they transition to a new school system. With ever-increasing focus on improved glycaemic control, it is important to recognise and collaboratively mitigate against disimprovements in care, occurring at times of stress due to predictable life events such as transition to a new school system.
