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ESPE and ESE joint clinical practice guidance for healthcare transition from paediatric to adult endocrine care

Authors

Developed by

European Society for Paediatric Endocrinology (ESPE) and European Society of Endocrinology (ESE) 

Significance

This pan-European consensus addresses the current lack of evidence-based transition guidance for endocrine conditions, which contributes to high rates of care discontinuity in young adults. By providing validated readiness tools and coordination protocols developed through multi-stakeholder collaboration across 10 countries, it offers actionable solutions to prevent loss to follow-up during this high-risk period.

Introduction

The transition from paediatric to adult healthcare represents a critical phase for adolescents and young adults with chronic endocrine conditions. This transition phase, varying across European healthcare systems, but typically spanning from early adolescence to young adulthood (ages 12-25), coincides with significant developmental, psychosocial, and medical changes. 

Studies demonstrate that young patients with endocrine disorders face substantial risks of loss to follow-up during transition, with rates varying by condition and measurement methods: 28%-43% for type 1 diabetes (with clinic attendance declining from 94% pre-transition to 57% post-transition), 44% for Turner syndrome, and 22%-61% for obesity. Poor transition management can compromise care, potentially leading to serious consequences for their long-term health outcomes and quality of life. 

While there is no universally accepted definition of successful transition, we define it as a process resulting in improved self-care skills, maintained adherence to care, and seamless establishment in adult services, measured by absence of care gaps, reduced emergency utilization, high patient satisfaction, and stable or improved disease-specific outcomes.

Endocrine conditions pose unique challenges during transition, due to their chronic nature, the need for regular monitoring, and the critical importance of treatment adherence. The complexity of care management is amplified by the diversity of endocrine conditions, ranging from pituitary disorders and thyroid diseases over adrenal disorders and diabetes mellitus to disorders/differences of sexual development, many of which directly affect pubertal development (spontaneous, delayed, or induced). This broad spectrum of disorders requires careful referral to an adult endocrinology centre equipped with the appropriate expertise to manage the specific condition alongside attention to developmental and psychosocial factors and healthcare system capabilities.

Existing guidelines on healthcare transition in endocrinology are disease-specific and leave many rare or less-discussed disorders without tailored transition guidance.

To address this, we propose a new European guidance based on a rigorous methodology combining a systematic review of scientific literature and extensive consultation with multidisciplinary experts. This guidance positions itself as a structural reference framework applicable to all endocrine conditions, designed to be adapted and complemented by disease-specific recommendations where they exist. It is not intended to replace disease-specific guidelines, but rather to provide a common organizational architecture that can be enriched and modulated according to the specificities of each condition. By building on existing research evidence and incorporating diverse expert opinions, we have developed practical recommendations that address the real constraints of European healthcare systems while maintaining scientific rigor.

European Journal of Endocrinology, Volume 194, Issue 2, February 2026, Pages G1–G10

Read the full Guideline

Hear from the Joint Guidance co-chairs

Guidance co-chairs Sebastian Neggers (Netherlands) for ESE and Enora Le Roux (France) for ESPE discuss their findings and recommendations.

Published
19/02/2026
Tags
Guidelines , Joint Guideline , Diabetes, Obesity, Metabolism and Nutrition , Reproductive and Developmental Endocrinology , Adrenal and Cardiovascular Endocrinology , Calcium and Bone , Environmental Endocrinology , Endocrine-related Cancer , Pituitary and Neuroendocrinology , Thyroid , Clinicians , Early Careers , (Allied) Health Professionals , Nurses , Patients , Public , European Women in Endocrinology ,
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