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Equitable Care for Diverse Individuals and Populations

(D24) Bridging the Gap: Smooth Transitions in Diabetes Care from Hospital to Home for Vulnerable Populations

Sunday, August 9, 2026
2:50 PM - 3:45 PM ET
CE: .75 CE
This presentation explores critical transition periods for patients with diabetes as they move across healthcare settings, particularly for underserved populations. Differences in care across these settings is examined, with emphasis on how clinical priorities shift from life-saving measures to long-term disease control. We discuss common barriers that complicate discharges for vulnerable populations such as communication breakdowns, inconsistent regimens, lack of access, and lack of timely follow-up.  We will share the development of our comprehensive approach to a transition clinic that applies strategies to optimize medication management, effective scheduling of outpatient follow-up, and patient-centered education to support self-management.

Learning Objectives:

At the completion of this activity, participants should be able to:
  • Discuss differences in glycemic management between inpatient and outpatient settings and how this affects discharge in people with new and pre-existing diabetes.
  • Identify at least three barriers to effective transitions of care for patients with diabetes following hospitalization in underserved populations.
  • Develop sample transition plans including medication reconciliation, follow-up scheduling, and patient education strategies for a recently discharged patient with diabetes.
Disclosure(s):
Elyssa Ely, DNP, APRN, AGPCNP-C, BC-ADM, CDCES, CNN-NP, CGCP: No financial relationships to disclose