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The process of transition should start in the pediatric setting (Fig. 1), when the patient is around 11–12 years old, and should involve sessions both with the child alone and together with the parents. It is suggested that one way to determine the understanding of the patients was to get them to explain their condition to their relatives. It may also be useful to provide mentors for the patients, who are older patients with the same condition and who can provide explanations from a different perspective. While it should be a partnership with patients, the children need to establish self-management. However, the transition team must be able to identify children who are at risk of life-threatening conditions, such as adrenal insufficiency or ketoacidosis, as young patients do not necessarily feel ill and may not recognize risks involved in not managing the condition correctly.

Few studies have associated a well-planned transition process with a better quality of life and a better controlled disease. One of those, which used 21-hydroxylase deficiency to confirm this, is widely described in a dedicated paper by Bachelot et al. [22].

Beyond this, a relationship based on confidence should be established between the pediatrician and the physician for adults, in order for that relationship, based on trust, to be the basis for the transfer of the adolescent from the pediatric system of care to the adult one. A recent report by an expert group of health care professionals concluded that there remains much to be done to ensure that the needs of adolescent patients with chronic endocrine conditions continue to be met during transition [23].