We provide multi-disciplinary services for children and adolescents with diabetes. Patients are seen every 3-4 months for comprehensive evaluations of their metabolic control. Patients are seen by a physician and frequently by a pediatric nurse practitioner, dietitian, and social worker at each visit. 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 and our satellite clinics on the north and south sides of Indianapolis, South Bend, and Evansville, IN.
All patients referred to Riley Hospital with newly diagnosed Type 1 diabetes mellitus are hospitalized for approximately two days of medical evaluation and individual instruction in basic survival aspects of diabetes management. Over 150 patients enter the program annually by this route. 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.
Members of the Riley Diabetes Team play an integral role at Camp John Warvel, the American Diabetes Association-sponsored summer camp. 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. Fellows attend this camp, as it provides a unique insight into the lives of their children with diabetes.
The Outpatient Pediatric Endocrine Service treats all endocrine problems of infancy, childhood and adolescence. These include growth disorders, Turner syndrome, ambiguous genitalia, delayed and precocious sexual development, goiters, congenital and acquired disorders of thyroid function, hypoglycemia, disorders of calcium metabolism, metabolic bone disease, adrenal disorders including congenital adrenal hyperplasia and adrenal insufficiency, diabetes insipidus and anterior pituitary dysfunction. There are over 30 outpatient clinics held each week at our main downtown Indianapolis location and at our satellite clinics located on the north and south sides of the city as well as in South Bend and Evansville, Indiana.
The Inpatient Pediatric Endocrine Service consists of a faculty attending, a Pediatric Endocrinology fellow, two pediatric residents, and one or two medical students. Rounding out the team is a group of dedicated diabetes educators that includes dietitians, nurse educators, and social workers. In addition to caring for patient on the Endocrine Service, faculty, fellows, and residents also provide consultative support to other clinical services at Riley Hospital for Children.
Special Clinics and Programs
Cancer Survivors Clinic
The Cancer Survivor Clinic is designed to follow children with endocrine diseases related to cancer treatment. This includes patients with pituitary dysfunction related to treatment of brain tumors, thyroid dysfunction in association with neck radiation and chemotherapy, and patients with pubertal disorders and gonadal insufficiency resulting from chemotherapy and radiation effects.
Youth Diabetes Prevention Clinic
The Riley Youth Diabetes Prevention Clinic is designed to evaluate and assess the needs of adolescents (ages 10 – 21) who have evidence of prediabetes or obesity in combination with multiple risk factors for the development of diabetes, including family history of diabetes in a first or second-degree relative, minority race/ethnicity, history of gestational diabetes in mother, acanthosis nigricans, irregular menstrual periods or polycystic ovary syndrome, and hypertension. Patients are followed by physicians/nurse practitioners, dietitians, and health coaches. For more information see Youth Diabetes Prevention Clinic. To refer a patient for services, please call 317.274.8812.
Type 2 Diabetes Clinic
The Riley Type 2 Diabetes Clinics treat youth with type 2 diabetes and complications related to diabetes. The Diabetes Team, consisting of physicians, nurse practitioners, dietitians, and social workers, provides comprehensive diabetes education and ongoing medical care in a setting appropriate for youth and their families.
Pediatric Metabolic Bone Disease Clinic
The Riley Pediatric Metabolic Bone Disease Clinic is run by Drs. Linda DiMeglio and Erik Imel, both of whom are members of the American Society for Bone and Mineral Research and are nationally recognized as experts in pediatric bone and mineral disorders. Treated conditions include osteogenesis imperfecta and other pediatric conditions associated with low bone density for age, sclerotic bone disorders including osteopetrosis, as well as calcium and phosphate disorders, including X-linked hypophosphatemic rickets.
Endocrine Testing Clinic
A comprehensive outpatient endocrine testing clinic provides for state-of-the-art evaluation of a broad range of endocrine conditions. Provocative serial tests done on an outpatient basis include growth hormone stimulation, leuprolide, standard and low-dose ACTH, glucose tolerance, insulin tolerance, water deprivation studies, and mixed meal stimulation. This facility is staffed by nurse specialists who provide pre-testing verbal and written education and psychosocial preparation for the procedure to the families of patients. Testing is performed in an area where there are appropriate diversion materials and a calm, quiet environment.
Newborn Screening Program for Congenital Hypothyroidism and Congenital Adrenal Hyperplasia
The Division of Pediatric Endocrinology and Diabetology is the site of the Indiana Congenital Hypothyroidism and Congenital Adrenal Hyperplasia Follow-up Programs. These programs represent a collaborative approach to newborn screening, with the goal of providing expedient and optimal care to every infant born in Indiana affected by these disorders. Pediatric endocrine fellows work closely with the program coordinator in the initial evaluation and treatment of infants with abnormal newborn screens. In addition, the programs provide ongoing consultative services for primary care physicians throughout the state. Educational activities for families and healthcare providers include parent brochures, written material, and formal lectures.
Hip Hop Obesity Clinic
This clinic was created to help deal with the increasingly prevalent problem of obesity in children. The clinic utilizes a team approach including physicians, pediatric dietitians, exercise physiologists, psychologists, nurses, and social workers. The evaluation includes assessment of insulin sensitivity in obese children and the effect of early intervention with a comprehensive weight management program.