When adolescents become adults: DGIM and DGKJ advocate for better care during the transition to adult medicine

17.07.2025 17:28

For many young people, the upcoming summer holidays mark the end of their school days and the beginning of a new chapter in their lives: They leave home, start university or vocational training, and take responsibility for their lives – and their health. However, this step can be particularly challenging for young people with chronic illnesses: The transition from pediatric to adult healthcare, the so-called transition process, is often inadequately organized.

The German Society for Internal Medicine (DGIM) and the German Society for Pediatrics and Adolescent Medicine (DGKJ) are calling for binding structures to ensure that this transition does not become a burden on health. Both professional societies have addressed the topic of transition in a joint special issue of [publication name missing]. Internal Medicine examined from an interdisciplinary perspective.

The transition to adulthood brings not only new freedoms for young people, but also new responsibilities for their own health and medical care. "Adolescents move from family-centered pediatrics to adult medicine, where they suddenly have to make independent decisions," explains Professor Dr. Dr. med. Dagmar Führer-Sakel, Chair of the German Society for Internal Medicine (DGIM) and Director of the Department of Endocrinology, Diabetology and Metabolism at Essen University Hospital.

This transition is particularly risky for young people suffering from complex conditions such as cystic fibrosis, type 1 diabetes, or rare, often congenital diseases with multiple typical symptoms, or who have received an organ transplant. "If preventative care and necessary therapies are not consistently continued, permanent damage, complications, and increased long-term mortality are likely," says Professor Dr. Ursula Felderhoff-Müser, President of the German Society for Pediatric and Adolescent Medicine (DGKJ) and Director of the Department of Pediatrics I at Essen University Hospital.

New disease patterns in adult medicine

Thanks to medical advances in recent decades, many patients who were previously pediatricians are now reaching adulthood. "Diseases that were previously only relevant in pediatrics now also affect internists," explains Professor Dr. Britta Siegmund, spokesperson for the German Society for Internal Medicine (DGIM) in the Transition Working Group, in which the DGIM, the German Society for Pediatric and Adolescent Medicine (DGKJ), and the German Society for Neurology (DGN) are jointly developing concepts for transitions in medical care.

„Many young people who had cancer in childhood develop internal medicine comorbidities later in life, such as heart and kidney problems as well as hormonal imbalances,“ says the expert, who heads the Department of Gastroenterology, Infectiology and Rheumatology at Charité Hospital in Berlin. This shift in care requires in-depth knowledge of childhood and adolescent diseases in internal medicine as well as closely coordinated transitions between specialties.

 Lack of structures and standards

Despite pilot projects and a guideline published in 2021, a smooth transition in Germany still depends heavily on the commitment of individual institutions. "There is a lack of comprehensive, reliable structures and clearly defined responsibilities," emphasizes Professor Dr. Lars Pape, spokesperson for the German Society for Pediatric and Adolescent Medicine (DGKJ) in the Transition Working Group, who also coordinated the AWMF S3 guideline on transition. The pediatrician criticizes the fact that the integration of specialized services that support adolescents during the transition from pediatric to adult medicine into standard care is also failing because—apart from a few pilot projects—they are not permanently funded. Without orderly transitions, there is a risk that young people will no longer receive adequate internal medicine care after leaving pediatric care—or will only find reconnection after a long period of interruption in their care.

Taking responsibility together

With the jointly published special issue, which runs concurrently in Internal Medicine and the Monthly Journal of Pediatrics With the publication of this special issue, the German Society for Internal Medicine (DGIM) and the German Society for Pediatric and Adolescent Medicine (DGKJ) aim to raise awareness among physicians about the relevance of the transition process. "We want to highlight solutions for bridging the gap between pediatric and adult medicine," says DGKJ President Felderhoff-Müser. The special issue examines, among other things, transition processes in diseases from the fields of endocrinology and diabetology, nephrology, hematology and oncology, pulmonology, gastroenterology, hepatology, and cardiology.

„Only by combining the expertise of pediatric and adolescent medicine on the one hand and internal medicine on the other can we prevent gaps in care and ensure the long-term health of these young people,“ adds DGIM Chair Professor Führer-Sakel. „Therefore, beyond the working group, we will also focus more strongly on the transition in our training and continuing education programs at our annual conferences,“ says the Essen-based internist, who will preside over the 2026 Congress of Internal Medicine.