During the transition from pediatric to adult diabetes care there is often a high rate of medical dropout and increased rates of acute and chronic complications. Building Connections: The Maestro Project was initiated in September 2002 by the Diabetes Education Resource for Children and Adolescents and the City of Winnipeg Regional Health Authority in Manitoba, Canada to examine the feasibility and acceptability of an administrative support and systems navigation service for young adults with type 1 diabetes. The participation rate on February 28, 2005 was 78.9 percent (373/473). Of the 323 young adult participants 18 to 30 years of age, 127 requested 230 community contacts for access care and education. Specifically, 46 re-referrals were made for specialty care (adult endocrinologists or general internists), 34 contact numbers were given for family physician care, and there were 121 contacts to reconnect with diabetes education and counseling services and 29 contacts for an optometrist. The first 22 years of the project have demonstrated the feasibility and acceptability of this model of service for young adults with type 1 diabetes as they move from pediatric to adult care.