Diabetes Clinical Service
Outpatient Diabetes Clinic
The Pediatric Diabetes Clinical Service provides multi-disciplinary services for children and adolescents with diabetes. Patients followed in these clinics are seen every 3-4 months for comprehensive evaluation of their metabolic control. Patients are seen by a physician and usually by a pediatric nurse practitioner at each visit and are also frequently seen by a dietitian and social worker. All patients followed in the Outpatient Clinics have access to 24-hour per day consultation with a nurse practitioner or physician. Clinics are located at Riley Hospital for Children, North Side, Riley Subspecialty Clinic at St. Francis Hospital, and the South Bend satellite clinic.
Inpatient Diabetes Education
All patients referred to Riley Hospital with newly diagnosed Type 1 diabetes mellitus are hospitalized for approximately three days of medical evaluation and individual instruction in basic survival aspects of diabetes management. Over 100 patients enter the program annually by this route. Patients are treated in the Parent Care Unit whenever possible, and parents begin participating in their child's care from the time of diagnosis.
All families are evaluated and educated by a multi-disciplinary team that includes at least one faculty level physician, endocrine fellow, pediatric resident, nurse practitioner, dietitian, and social worker. Patients are discharged when they demonstrate adequate competence in the technical skills they have learned. They are then followed by phone at least twice per week by a nurse practitioner until the patient's blood sugars stabilize. They are also scheduled for further education in the ADAPT outpatient education program.
Members of the Riley Diabetes Team have played an integral role in the administration and personnel of Camp John Warvel, the American Diabetes Association-sponsored summer camp. Fellows are strongly encouraged to attend this camp, as it provides a unique insight into the lives of their children with diabetes. This annual weeklong, sleep-away camp for children with diabetes provides fun and educational experiences for children from 7-18 years of age. The camp also provides diabetes training experiences for medical students, nursing students, parents, dietary interns, and other individuals and medical professionals with an interest in diabetes.
Insulin Pump Program
Continuous Subcutaneous Insulin Infusion (CSII) through the use of an insulin pump represents an alternative method of insulin administration for motivated and compliant patients. Recognizing the advantages of insulin pump therapy, the Riley Diabetes Team has greatly expanded its use of insulin pumps for selected children with diabetes. Eligible insulin pump candidates are usually on intensive injection therapy (MDI) and have demonstrated proficiency with carbohydrate counting and a high level of responsibility with daily diabetes management. A full time dedicated pump nurse performs the initial education in pump use and provides telephone follow up for questions and adjustments. Many children using insulin pumps are followed together in pump clinics. Pump clinics are structured according to a group format, in which the patients and parents meet as separate groups with members of the diabetes team.