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diabetes

comprehensive, multidisciplinary care for patients with type 1 and type 2 Diabetes

Dayton Children’s Hospital provides comprehensive, multidisciplinary care for patients with type 1 and type 2 diabetes. We are passionate about helping these children manage their condition and live normal, active lives.

The diabetes team is led by our endocrinologists and also includes nurses and dietitians, a social worker and a psychologist. They take a personal approach with patients and families, always making time to provide education and support. The team includes nurses who are certified diabetes educators, which means they have undergone intensive training to teach people with diabetes how to manage their condition.

Our goal is to help children take responsibility for managing their health. We work with families to create a personalized care plan and review it regularly as the child’s needs change. Our team cares for patients as they transition into adulthood, usually around the age of 22.

Patients and families appreciate our thorough and personal approach, knowing that they can contact us by phone or email with questions or concerns. They can also communicate with our team through MyKidsChart.

conditions

Dayton Children’s provides expert care for patients with type 1 and type 2 diabetes as well as caring for children with cystic fibrosis-related diabetes. These diseases are very different from one another, and they require different kinds of care.

type 1 diabetes

Type 1 diabetes can develop quickly, taking patients and parents by surprise. It occurs when the body’s immune system destroys cells in the pancreas that produce the hormone called insulin.

Insulin is essential in helping the body convert sugar (called glucose)into energy. After a person eats, the digestive system breaks down carbohydrates to create glucose. Insulin moves glucose into the body’s cells. Without it, glucose builds up in the blood instead. This can lead to dehydration, weight loss and a life-threatening condition called diabetic ketoacidosis, or DKA. DKA occurs when the body starts breaking down fat cells in a desperate attempt to get energy.

diagnosing type 1 diabetes

Most of the time, children are diagnosed with type 1 diabetes after a parent, caregiver or teacher notices symptoms such as excessive thirst, frequent urination, weight loss, nausea and vomiting, and fatigue. Doctors can confirm a diagnosis of type 1 diabetes using a urine test and/or blood test.

There is no cure for this disease. But children with type 1 diabetes can live full and active lives with the help of intensive insulin therapy, which involves administering shots or using an insulin pump to deliver insulin several times a day.

Adjusting to Type 1 diabetes can be challenging, but our caring team can help you and your child be successful.

type 2 diabetes

Type 2 diabetes occurs when cells in a child’s body become resistant to insulin, causing glucose to build up in the bloodstream. Over years, this build-up can reach dangerous levels and lead to complications such as heart disease, blindness and kidney failure.

Type 2 diabetes is almost always preventable. The single greatest risk factor is excess weight, although family history can play a role. Your child’s primary care physician can help you understand your child’s risk factors and work to reduce them through diet and exercise. Once a child has been diagnosed with type 2 diabetes, a healthy diet, exercise, insulin and in some cases, oral medication, can help them manage it.

diagnosing type 2 diabetes

The symptoms of type 2 diabetes in children develop slowly. They include unexplained weight loss, increased hunger or thirst, frequent urination and fatigue, among others. If you notice these symptoms in your child, take him or her to the doctor as soon as possible. A urine and/or blood test can help determine if your child has a form of diabetes. If your child is overweight, the doctor may need time to determine whether the cause is type 1 or type 2 diabetes.

cystic fibrosis-related diabetes

Cystic fibrosis-related diabetes (CFRD) is a unique form of diabetes that is common in people with cystic fibrosis. Our endocrinologists would work closely with the child’s pulmonary team to manage this additional disease caused by their CF. CFRD shares features of both type 1 and type 2 diabetes. It is recommended that any child with CF age 10 and older be tested every year for CFRD.

Learn more about CFRD from the Cystic Fibrosis Foundation.

additional information

visiting the diabetes clinic

After your child receives a diabetes diagnosis, an appointment will need to be scheduled for follow-up one to two weeks after they are discharged and then in one month. After initial follow-up, routine appointments will be scheduled every two to three months.

In order for the diabetes clinic appointments to go as smoothly as possible please follow the guidelines below for diabetes specific patients. For other clinic guidelines please visit our for current patients section.

  • When coming to your clinic appointment you will be seen by the nurse, the physician and you may also be seen by a dietitian and social worker if necessary. Please allow enough time to be seen by these team members. If you and your endocrinologist determine that your child would benefit from a referral to our psychologist, it will be arrange by our team.
  • Please come prepared with your records for the last two weeks, all home meters, insulin pump, list of prescriptions, and any questions or concerns you have.
  • Fasting lab work: Fasting labs are done on a yearly basis. You must arrive in the lab one hour before your appointment. This will allow enough time for blood work to be drawn, insulin given, and breakfast eaten. When finished, go immediately to the diabetes clinic and sign in.
  • Routine clinic: At routine visits, a hemoblobin A1c lab is drawn. This can be drawn in the clinic. If you chose to go to lab to have this drawn, then you must arrive in the lab 30-60 minutes before your scheduled appointment. After blood is drawn, go immediately to the diabetes clinic and sign in.
  • Bring your meter and/or insulin pump to every appointment. Your appointment may need to be rescheduled if these items are not brought with you because this information is needed to accurately determine what changes need to be made in your treatment plan.
  • Remember your child’s snack or meal if the visit is scheduled close to meal or snack time.

communicating with the diabetes team

While you can always email the diabetes team or contact us through MyKidsChart please follow these steps to contact us about:

illness: If your child is ill, has moderate or large ketones, or has an emergency, please call 937-641-3487 for assistance. If this is after hours, please call the hospital operator at 937-641-3000 and ask to speak to the endocrinologist on call.

When you call, please have the following information ready:

  1. Blood sugars and ketone results.
  2. Insulin doses

blood sugars: You can submit blood sugar records for review through:

  • Our online form – Preferred method
  • Email diabetesnurse@childrensdayton.org
  • Call our blood sugar line 937-641-3474. Please do not leave a message requesting the nurse to call you back for blood sugars. This will only delay the physician reviewing the blood sugars and adjusting doses.
  • Fax to 937-641-5878

You will need to include the following information.

  1. Your child’s name and date of birth. Please spell your child’s name.
  2. Your child’s current doses
  3. The date, time, and actual blood sugar numbers

The dosing changes will be returned to you by phone or e-mail.

prescriptions: please leave the following information on the prescription line by calling 937-641-3474.

  1. Your child’s name and date of birth. Please spell your child’s name
  2. The refill needed.
    • Ex. Test strips – be sure to leave the type of strips so the correct refill will be provided (ex. Aviva Plus, Contour, Freestyle Lite, Smart View, True-Test, Ultra, Verio, etc.)
  3. 30 day or 90 day supply (this is dependent upon your insurance)
  4. The pharmacy name and phone number
    • Requests are faxed to the pharmacy you specify unless you request the prescription to be mailed or picked up.
    • If you are requesting a 90 day supply, please also provide the pharmacy city and state.

non-emergency requests: These include: forms for school, work, or driving, general questions, etc.

  • For any form to be completed and sent by the diabetes team, a release of information form must be signed by the parent or child if 18 yrs. of age or older.
  • A release of information is good for one year.
  • Please allow up to two weeks for these forms to be completed.

using technology to manage diabetes

Today’s technology makes it possible for children to manage their diabetes better than ever before. Our team is up to date on the most advanced blood glucose meters, continuous blood glucose monitors, insulin pumps and phone apps. The endocrinology team sponsors quarterly informational insulin pump meetings. The pump manufacturers are invited to this meeting to provide information on their products.

family support resource directory

Families of children with type 1 or type 2 diabetes can find resources such as camps for children with diabetes or support groups in our Family Support Resource Directory.

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additional resources

If you are currently a patient of the endocrinology diabetes clinic at Dayton Children’s please visit our additional resources page for additional forms and resources to help you manage your care.

contact us request an appointment

The endocrinology department welcomes phone calls to 937- 641-3487 during our normal business hours of 8:00 am to 5:00 pm. After hours, you can dial 937-641-3000 and ask that the endocrinologist on call be paged.

A physician referral is necessary prior to the child’s first outpatient visit. All follow up appointments will be made during your clinic visit or by calling central scheduling at 937-641-4000.

ED nurses receive national certification

Nurses have received their national certification from The Board of Certification for Emergency Nursing (BCEN®) and the Pediatric Nursing Certification Board (PNCB®).

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