# Diabetes — GCMD Library living collection

Everything in the library about diabetes — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 64 cited statements

## Episodes
### Surgical Management
- [Kanika Bowen-Jallow, MD and Faisal Qureshi, MD - 2024 Pediatric Bariatric Surgery Update Course](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958) — video · 19:25 · [machine version](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958.md)

### Evidence & Research
- [Adolescent Bariatric Surgery: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371) — video · 32:47 · [machine version](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371.md)

### Long-Term Care
- [Transition of Care - A general overview by Silja Kosolove](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652) — video · 21:33 · [machine version](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=0) Introduction and Study Overview (Ep 1)
- [4:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=240) Rationale for Aggressive Treatment and Mortality Risk (Ep 1)
- [8:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=480) Cincinnati FAS-5 Study Design and Retention (Ep 1)
- [13:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=780) FAS-5 Weight Loss Outcomes and BMI Trajectories (Ep 1)
- [17:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1020) Comorbidity Remission and Incidence Rates (Ep 1)
- [20:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1200) Residual BMI and Metabolic Harm (Ep 1)
- [23:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1380) Micronutrient Deficiencies in FAS-5 (Ep 1)
- [24:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1440) Swedish AMOS Study Design and Weight Outcomes (Ep 1)
- [28:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1680) AMOS Comorbidity Resolution and Complications (Ep 1)
- [30:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1800) Teen Labs Consortium: Current Status and Future Aims (Ep 1)
- [34:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=2040) Summary and Window of Opportunity (Ep 1)
- [0:01](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1) Introduction and the case against abrupt transfer (Ep 2)
- [3:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=180) Clinical and age considerations in transition (Ep 2)
- [7:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=420) Developmental stage and brain maturation (Ep 2)
- [12:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=720) Life circumstances and competing transitions (Ep 2)
- [15:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=900) System approach: Transfer versus transition (Ep 2)
- [18:20](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1100) Professional education and youth-friendly care (Ep 2)
- [20:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1200) Resources and team approach (Ep 2)
- [21:17](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1277) Closing summary (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=0) Preoperative and Intraoperative ERAS Protocol (Ep 3)
- [6:25](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=385) Postoperative Care and Early Recovery (Ep 3)
- [13:43](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=823) Diet Advancement and Clinical Controversies (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "Cardiovascular mortality begins to climb in the overweight range and increases definitively for adolescents at or above the 95th percentile BMI, leading to early cardiovascular death." — Thomas Inge (host_summary) [Ep 1 · 4:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=240)
- "FAS-5 study achieved 81% participation (58 of 74 eligible) at 8-year follow-up, mostly with in-person research visits." — Thomas Inge (clinical) [Ep 1 · 8:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=480)
- "At 8-year mean follow-up, gastric bypass patients had a mean BMI decline of 29%." — Thomas Inge (clinical) [Ep 1 · 13:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=780)
- "Baseline BMI strongly correlates (R=0.75) with follow-up BMI: patients starting with BMI in the 60s end above 40, while those starting in the 40s reach near-normal BMI." — Thomas Inge (clinical) [Ep 1 · 15:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=900)
- "Remission rates at 8 years: 88% for diabetes, 64% for dyslipidemia, 75% for hypertension." — Thomas Inge (clinical) [Ep 1 · 17:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1020)
- "Among those without baseline comorbidities, incidence rates were 0% for diabetes, 50% for dyslipidemia (small denominator), and 3 of 29 developed hypertension." — Thomas Inge (clinical) [Ep 1 · 18:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1080)
- "Follow-up BMI predicts probability of hypertension, dyslipidemia, high CRP, high insulin, insulin resistance, and low HDL; higher residual BMI is metabolically harmful." — Thomas Inge (clinical) [Ep 1 · 20:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1200)
- "At 8 years, FAS-5 cohort showed low iron stores with anemia, elevated PTH, and low vitamin D in substantial numbers." — Thomas Inge (clinical) [Ep 1 · 23:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1380)
- "In AMOS study, non-surgical controls with severe obesity gained weight over 5 years (BMI 42→45)." — Thomas Inge (host_summary) [Ep 1 · 25:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1500)
- "AMOS gastric bypass patients had dramatic BMI reduction from 45 to 30, stable at 5 years, similar to adult controls and SOS cohort." — Thomas Inge (host_summary) [Ep 1 · 26:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1560)
- "AMOS showed 83% dyslipidemia remission, 12 of 12 hypertension cases resolved, and 75% inflammation (CRP) resolved." — Thomas Inge (host_summary) [Ep 1 · 28:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1680)
- "AMOS had high internal hernia rates due to unclosed mesenteric defects at laparoscopic gastric bypass; closing defects prevents this complication." — Thomas Inge (clinical) [Ep 1 · 29:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1740)
- "In AMOS, low vitamin D was found in >50% of gastric bypass patients and also in controls; low B12 and iron deficiency anemia were noted." — Thomas Inge (host_summary) [Ep 1 · 30:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1800)
- "Teen Labs enrolled 242 adolescents (161 bypass, 67 sleeve, 14 band) at 5 centers; median age now 24, with 203 completing 5-year visits (72% in-clinic, 17% field)." — Thomas Inge (clinical) [Ep 1 · 31:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1860)
- "Adding 33 sleeve gastrectomy patients to Teen Labs will provide 80% power to compare bypass vs. sleeve for outcomes including blood pressure, PTH, HDL, and BMI." — Thomas Inge (clinical) [Ep 1 · 32:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1920)
- "Severely obese patients have greater bone mineral density due to loading; rapid weight loss after bariatric surgery drops bone mass, raising the question of whether it stabilizes or continues to decline (bariatric bone disease)." — Thomas Inge (clinical) [Ep 1 · 34:00](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=2040)
- "Operating earlier after diagnosis of severe obesity may yield lower residual BMI and better long-term metabolic outcomes." — Thomas Inge (opinion) [Ep 1 · 32:47](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1967)
- "FAS-5 study had a residual mean BMI of 38 at 8 years, with many patients remaining severely obese; this residual obesity is metabolically harmful." — Thomas Inge (clinical) [Ep 1 · 32:47](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1967)
- "The 33 new sleeve patients can be enrolled within a year from consortium sites with ongoing clinical follow-up, enabling long-term comparisons." — Thomas Inge (clinical) [Ep 1 · 32:17](https://library.globalcastmd.com/watch/adolescent-bariatric-surgery-pediatric-obesity-2017-371?t=1937)
- "ERAS recommendations for bariatric surgery include carbohydrate drink the night before surgery and clear liquids up to 2 hours prior to surgery" — Kanika Bowen-Jallow (host_summary) [Ep 3 · 0:34](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=34)
- "Aprepitant is given in pre-op 1-2 hours prior to surgery and has become standard in patients with high risk for post-operative nausea" — Kanika Bowen-Jallow (clinical) [Ep 3 · 1:30](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=90)
- "Multiple preoperative pills given in pre-op area have not been observed in the stomach during intraoperative scoping" — Kanika Bowen-Jallow (clinical) [Ep 3 · 2:00](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=120)
- "DVT prophylaxis with Lovenox or subcutaneous heparin is administered at the start of the case, though practices vary greatly among surgeons" — Kanika Bowen-Jallow (clinical) [Ep 3 · 3:00](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=180)
- "ASMBS recommends DVT prophylaxis intraoperatively and postoperatively before discharge, but most patients do not go home on DVT prophylaxis unless there is a specific indication such as family history" — Kanika Bowen-Jallow (host_summary) [Ep 3 · 3:30](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=210)
- "Minimizing narcotics helps prevent postoperative nausea, achieved by running medications like propofol at low baseline during anesthesia" — Kanika Bowen-Jallow (clinical) [Ep 3 · 3:49](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=229)
- "New literature demonstrates laparoscopic TAP block is not superior to local infiltration of incisions for pain control" — Kanika Bowen-Jallow (host_summary) [Ep 3 · 4:10](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=250)
- "Ondansetron is used in the OR prior to extubation, while aprepitant is given preoperatively in holding to achieve synergistic anti-emetic effect" — Kanika Bowen-Jallow (clinical) [Ep 3 · 4:00](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=240)
- "The number one concern after sleeve gastrectomy is nausea, retching, and vomiting" — Kanika Bowen-Jallow (clinical) [Ep 3 · 4:30](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=270)
- "Haloperidol is not used due to sedative effects that interfere with waking patients in the PACU" — Kanika Bowen-Jallow (clinical) [Ep 3 · 4:44](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=284)
- "Total daily acetaminophen dose should not exceed 4000 mg per day when combining IV and oral administration" — Kanika Bowen-Jallow (clinical) [Ep 3 · 5:10](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=310)
- "Pure oxycodone immediate-release is the ERAS recommendation for narcotic use if needed because it does not contain acetaminophen" — Kanika Bowen-Jallow (host_summary) [Ep 3 · 5:40](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=340)
- "Oxycodone is not routinely needed and patients are not discharged home on narcotics" — Kanika Bowen-Jallow (clinical) [Ep 3 · 6:10](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=370)
- "80% of pediatric bariatric patients spend one night in the hospital" — Faisal Qureshi (epidemiological) [Ep 3 · 7:10](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=430)
- "Expected postoperative pain level is 3 out of 5" — Faisal Qureshi (clinical) [Ep 3 · 7:25](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=445)
- "TAP blocks have improved pain control and reduced nausea compared to non-exparel or exparel local anesthetic at port sites, with most patients going home the next day" — Faisal Qureshi (clinical) [Ep 3 · 7:35](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=455)
- "Pure exparel diluted with normal saline is used for TAP blocks, performed immediately after camera insertion and epigastric port placement, adding only 3-5 minutes to the case" — Faisal Qureshi (clinical) [Ep 3 · 7:59](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=479)
- "Ice chips are started within 4-6 hours postoperatively" — Faisal Qureshi (clinical) [Ep 3 · 8:30](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=510)
- "Hematocrit is checked approximately 6 hours postoperatively" — Faisal Qureshi (clinical) [Ep 3 · 8:40](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=520)
- "Sequential compression devices and Lovenox are used for DVT prophylaxis" — Faisal Qureshi (clinical) [Ep 3 · 8:50](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=530)
- "Clear liquids are started on postoperative day one, with patients circling 1 ounce of liquids every 15 minutes with clear proteins and water for 3-4 hours before discharge" — Faisal Qureshi (clinical) [Ep 3 · 9:05](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=545)
- "Patients are discharged home without narcotics if they tolerate liquids without nausea or significant pain, with TAP block providing analgesia for 2-3 days" — Faisal Qureshi (clinical) [Ep 3 · 9:40](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=580)
- "NSAIDs are not generally given at home and no pills are allowed for 6 weeks, though chewables are acceptable" — Faisal Qureshi (clinical) [Ep 3 · 10:00](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=600)
- "Patients return to school within 5 days to 1 week postoperatively" — Faisal Qureshi (clinical) [Ep 3 · 10:20](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=620)
- "The rationale for avoiding straws is to prevent rapid drinking rather than air ingestion, though this may be surgical myth" — Faisal Qureshi (opinion) [Ep 3 · 10:00](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=600)
- "Small pills are well-tolerated postoperatively because the esophagus is much bigger than any pill" (opinion) [Ep 3 · 10:50](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=650)
- "Week 1 diet consists of 1 ounce of fluid every 15 minutes with goal of 40 ounces of liquids and 40 grams of protein" — Faisal Qureshi (clinical) [Ep 3 · 13:43](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=823)
- "Week 2 diet advances to blended soups consistency with no lumps, bumps, or chunks, targeting 60 grams of protein and 60 ounces of fluids" — Faisal Qureshi (clinical) [Ep 3 · 14:05](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=845)
- "Weeks 3-6 consist of soft diet with applesauce or mashed potatoes consistency, 60 grams of protein, 64 ounces of water, 600-800 calories, and initiation of exercise" — Faisal Qureshi (clinical) [Ep 3 · 14:25](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=865)
- "Week 4 onwards maintains 60 grams of protein, 64 ounces of water, 600-800 calories, and 60 minutes of exercise daily" — Faisal Qureshi (clinical) [Ep 3 · 14:55](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=895)
- "After week 6, patients advance to regular diet with small portions, moist cooking methods, and 1/4 to 1/2 cup portion sizes" — Faisal Qureshi (clinical) [Ep 3 · 15:09](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=909)
- "Levsin (hyoscyamine) is effective for patients struggling with fluid intake or swallowing difficulty in the first few days after surgery" (clinical) [Ep 3 · 15:09](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=909)
- "Adult bariatric surgeons use Air Seal insufflation system to maintain stable low pressures (10 mmHg) by regulating pressure second-to-second rather than every 20-30 seconds like standard insufflators" — Kanika Bowen-Jallow (host_summary) [Ep 3 · 16:31](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=991)
- "Operating at lower insufflation pressures results in less TNF-alpha production and decreased postoperative pain" — Kanika Bowen-Jallow (host_summary) [Ep 3 · 17:30](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=1050)
- "Stryker or Storz insufflators in pediatric mode check pressure more frequently, allowing better pressure control" (clinical) [Ep 3 · 18:00](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=1080)
- "90% of adolescent bariatric procedures performed are sleeve gastrectomies" — Kanika Bowen-Jallow (epidemiological) [Ep 3 · 19:09](https://library.globalcastmd.com/watch/kanika-bowen-jallow-md-and-faisal-qureshi-md-2024-pediatric-bariatric-surgery-update-course-7958?t=1149)
- "If adolescents are left to survive on their own without proper transition, they will not adhere to care in adult hospitals and their health outcomes will diminish, with many not surviving." — Silja Kosolove (clinical) [Ep 2 · 0:01](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1)
- "Poor health from inadequate transition leads to greater expenses, with emergency admissions and unplanned procedures being more expensive than planned care." — Silja Kosolove (epidemiological) [Ep 2 · 1:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=60)
- "Patients should not be transferred during clinically unstable periods requiring frequent inpatient care, treatment regime changes, or new surgical procedures." — Silja Kosolove (clinical) [Ep 2 · 3:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=180)
- "In many countries the age limit from pediatric to adult care has risen and is now most often 18 years, though in Finland it remains 16 years." — Silja Kosolove (guideline) [Ep 2 · 4:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=240)
- "When 16-year-olds are transferred to adult care, adult professionals are mostly not familiar with legal requirements for child protection notifications, and the rights of the child are not properly addressed." — Silja Kosolove (clinical) [Ep 2 · 4:30](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=270)
- "Cognitive skills develop logically during adolescence, but psychosocial skills take a dip during teenage years, with the timing and depth of this dip being very individual." — Silja Kosolove (clinical) [Ep 2 · 8:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=480)
- "Illness, nutrition, and stress affect adolescent development and may lead to the developmental conflict being greatest right at the time when young people should leave pediatric care." — Silja Kosolove (clinical) [Ep 2 · 9:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=540)
- "The last bits of the human brain to develop are in the frontal lobe, where planning for the future, problem-solving, and emotional and behavioral control are learned." — Silja Kosolove (clinical) [Ep 2 · 10:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=600)
- "Emotional centers in the adolescent brain develop earlier than frontal lobe control centers, creating a situation where young people have strong emotions but underdeveloped impulse control." — Silja Kosolove (clinical) [Ep 2 · 10:40](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=640)
- "Medical follow-up can resemble the relationship young people have with their parents, and as they struggle for autonomy they may rebel against medical care." — Silja Kosolove (clinical) [Ep 2 · 14:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=840)
- "In many studies, quality of life has been better when judged by young people themselves than when judged by their parents or carers." — Silja Kosolove (epidemiological) [Ep 2 · 15:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=900)
- "Transfer is a simple moving of paper, while transition is a prepared process with someone on the other side saying welcome and continuing the care relationship." — Silja Kosolove (clinical) [Ep 2 · 16:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=960)
- "Patients should be met alone from the age of 12, at least for part of the appointment." — Silja Kosolove (guideline) [Ep 2 · 17:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1020)
- "Treatment advice should be given directly to the patient even if the parent is in the room." — Silja Kosolove (guideline) [Ep 2 · 17:20](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1040)
- "There is growing evidence that single days of coaching for transition have very low or no impact." — Silja Kosolove (epidemiological) [Ep 2 · 18:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1080)
- "There is growing evidence that joint consultations with pediatric and adult teams both present builds trust and may lead to better outcomes." — Silja Kosolove (epidemiological) [Ep 2 · 18:20](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1100)
- "In adult healthcare during the first couple of years after transition, consultations should be more frequent and longer than for other adult patients because trust takes time." — Silja Kosolove (guideline) [Ep 2 · 19:00](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1140)
- "Young people need one named contact person between consultations, though most times they don't call, providing a sense of security." — Silja Kosolove (guideline) [Ep 2 · 19:40](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1180)
- "There is strong evidence that continuity of care (management continuity, information continuity, and relationship continuity) leads to better outcomes in transition." — Silja Kosolove (epidemiological) [Ep 2 · 20:20](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1220)
- "The process of transition cannot be on the shoulders of one single person but must be a holistic approach in the whole hospital so it continues when individuals retire or fall ill." — Silja Kosolove (guideline) [Ep 2 · 20:30](https://library.globalcastmd.com/watch/transition-of-care-a-general-overview-by-silja-kosolove-7652?t=1230)

## Changelog
- Sep 25: 3 items added automatically

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