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Clinical Programs

The U-M Pediatric Diabetes team offers comprehensive evaluation, treatment, and resources to help children with diabetes live long, productive lives. Our diabetes program is one of the largest established programs in Michigan. We provide outpatient care for diabetes at C.S. Mott Children’s Hospital and at the Northville Health Center.

 

We care for children from newborn through the young adult years, tailoring treatment plans to each individual and their personal needs and lifestyle. We offer a range of diabetes management therapies, including insulin pump or injection based basal/bolus therapy. In addition to insulin therapy, blood glucose monitoring, using blood glucose meters and/or a continuous glucose monitor (CGM), is an important part of managing your child's diabetes. We will also work with your family to develop a plan for balanced nutrition and regular exercise. All care is coordinated through a team approach with your child’s primary care physician to ensure complete care for your child every step of the way. 

 

Our program is built on the philosophy that diabetes patients thrive best when they and their families take an active role in their own disease management. Families play an integral role in the treatment plans we design based on the child’s needs and the family’s lifestyle.

Our Mission

The mission of Michigan Medicine is to provide excellence and leadership in the areas of: patient care/services, education, and research. In keeping with this mission, the Pediatric Diabetes Self-Management Education and Support Services provides evidence based diabetes care and education services that promote self-management, optimal blood glucose control, and prevention of acute and long term complications of diabetes. 

 

We are here to support you as you care for your child’s health. Our goal is to ensure that each child is able to fully participate in all childhood activities and avoid the possible long-term complications of diabetes.

 

Our commitment to you is to:

1. Provide the highest quality and most up-to-date medical care through our multidisciplinary team of experts in diabetes care. The multidisciplinary team consists of: a Medical Doctor (MD) trained in diabetes care for children and adolescents, Registered Nurses (RN), Registered Dietitians (RD), Social Workers (MSW), and Psychologist (PhD).

2. Provide child and family with self-management knowledge to make informed decisions and to maintain or improve health and quality of life through your own initiative. 

3. Empower your child and family with self-management skills fostering independence and improved quality of life. 

4. Provide a Diabetes Medical Management Plan for School (DMMP) every year. 

5. Provide education and resources that are age appropriate as your child grows.

6. To return phone calls regarding diabetes management. Please visit the Contact page for details of how to get in touch. Calls are screened and managed by nurses and dietitians that are trained in the acute management of diabetes problems. The nurses and dietitians will determine if physician contact is necessary based on the clinical need.​

7. Provide active patients under our management with a complete set of prescriptions once a year.

8. Assist in a successful transition to adult Diabetes care.

 

We are a team! Your commitment to your child and to the Pediatric Diabetes Self-Management Education and Support Services is essential to the goal of improving the health and quality of life for your child. Patients and families do best with diabetes care when they take an active role in their own management.

Diabetes Education

Education and training are critical components of the U-M Pediatric Diabetes program. We provide in-depth instruction for families on how to manage diabetes with a focus on giving families confidence in their ability to manage their child's disease. Self-management is a cornerstone of our program, empowering patients and families to make informed decisions on how to maintain or improve health and quality of life through their own initiative. Families will learn self-management skills and learn to make lifestyle changes so that children can participate fully in all activities while avoiding long-term complications. Our program also offers resources to help families address the special needs of children with diabetes in the school setting, working collaboratively with school personnel to meet these needs.

Our diabetes education program is recognized by the American Diabetes Association and has been certified by the Michigan Department of Community Health (MDCH) since June 2001. The recognition and certification process is based on National Standards for Diabetes Self-Management Education, American Diabetes Association, and MDCH requirements.​

The U-M Pediatric Diabetes education program includes group classes for children, adolescents, and families. See below for descriptions of our class offerings. Please note that some classes are only offered on an as needed basis.

This new diabetes education program includes:

1. Virtual Class: Led by Dr. Joyce Lee, MD, MPH and/or a Certified Diabetes Care and Education Specialist (CDCES), this one-time class held over live videoconference will provide training on viewing, interpreting, and utilizing diabetes data for self-management. 

 

Upcoming class dates (all from 6-8PM):​​​

  • September 20, 2023

  • October 18, 2023

 

2. Online Hub: Participants will also have access (through an online education website called Canvas) to comprehensive educational videos and materials that cover topics including: how to download device data, how to interpret diabetes data and recognize patterns, understanding insulin dosing and how behaviors can affect blood sugar, and how to adjust insulin doses.

For a limited time, there is no charge to participate.

 

Please note: Your child must be a patient of the U-M Pediatric Diabetes Clinic to enroll.

If you have questions about the program or would like to register, contact Ashley Garrity (ashleyna@med.umich.edu or 734-936-2452) OR scan the QR code to request information.

  • What do I need to do to go back to school?
    Going back to school after a new diabetes diagnosis can be stressful. It is important that you are prepared to make the transition as smooth as possible. Be sure you have your supplies and tell the school what to do in case of emergencies, like extremely low blood sugars. Talk to your diabetes care team about developing a Diabetes Medical Management Plan (DMMP) and set up a meeting to create a 504 plan with your school administrators. If you have any questions about your child’s health, do not hesitate to ask us.
  • What is a school plan (DMMP)?
    A Diabetes Medical Management Plan (DMMP) outlines the specific care your child needs at school. Diabetes management is different for everyone. Some students inject insulin with a syringe and vial, some use insulin pens, and some use pumps and CGMs (continuous glucose monitors). Students often have different carb ratios at different times of the day and require different amounts of insulin. Some students manage their diabetes independently, and some younger or newly diagnosed students may need help with all aspects of their diabetes care. Your pediatric endocrinologist's orders will be specific for your child's health and well-being. Drafting a DMMP takes place between you and your care team. This is typically done in the summer months before your child returns to school. Please do not hesitate until school is about to start to bring this issue to our care team, as we typically have higher volumes of forms to complete at this time.
  • What is a 504 Plan? Do I need one?
    A 504 plan is a formal, legal action plan made with your child’s school that outlines the school's responsibilities in managing your child’s diabetes. For a sample 504 plan, click here. ​ It is a good idea for you to come up with a Diabetes Medical Management Plan (DMMP) with the school before each school year. The U-M Pediatric Diabetes care team can help facilitate this conversation if you would like. The 504 plan can help reinforce the commitments made in the DMMP. Remember, the school staff are likely not medical professionals; be patient and remember that you are a team in taking care of your child's health and well-being.
  • What is an IEP? Do I need one?
    If a student with diabetes has special education needs that qualify under the Individuals with Disabilities in Education Act (IDEA), an Individualized Education Plan (IEP) may be needed instead of a 504 plan. An IEP is a document that outlines what the school is going to do to meet the child's individual education needs. To qualify for an IEP, a child must have an impairment that affects his or her academic performance.
  • My child's school won't let my child attend because they do not have a school nurse. What can I do?
    It is not legal for your child to be barred entry to any public or private school that receives federal funding because of a T1D diagnosis. Even if your school does not have a nurse, all schools that receive public funds are required to train a responsible adult to carry out the Diabetes Medical Management Plan (DMMP). They cannot exclude a child from school because of type 1 diabetes or force parents to come to school to handle the diabetes care activities. It is important to remember, the school staff are likely not medical professionals; be patient and remember that you are a team in taking care of your child's health and well-being. ​ If you continue to have trouble with establishing the school's role in your child's care, you may contact us about creating a 504 plan.
  • My child's school wants me to come in and perform blood glucose checks and insulin injections. What can I do?
    You are not required to leave work or disrupt your schedule to perform routine care for your child's diabetes while they are at school. Even if your school does not have a nurse, all schools that receive public funds are required to train a responsible adult to carry out the Diabetes Medical Management Plan (DMMP). They cannot exclude a child from school because of type 1 diabetes or force parents to come to school to handle the diabetes care activities. It is important to remember, the school staff are likely not medical professionals; be patient and remember that you are a team in taking care of your child's health and well-being. ​ If you continue to have trouble with establishing the school's role in your child's care, you may contact us about creating a 504 plan.
  • What supplies should I take to school?
    Your Diabetes School Kit should include: Extra glucose meter Blood glucose test strips Juice boxes, glucose tablets, and/or glucose gel Glucagon Granola bars or other small snack Ketone strips Bottled water (if your child won’t drink school water) ​Your child should always have access to something to treat a low blood sugar. Snacks or glucose tablets should be kept with the student, in case of a fire drill/lock-down/shelter in place, as well as in classroom, in the locker room, and on the school bus. For younger children, ask the teacher to keep juice boxes or glucose tabs in their desk. Be sure any substitute teachers, including substitute bus drivers and office staff, also know about this arrangement. Older children should carry supplies in their backpacks or in their pockets.
  • Where should I keep my glucagon at school?
    It is very important that your glucagon is kept somewhere accessible where others can find it in case of emergency. If you leave your glucagon in your school's office, you need to have a plan in place for someone to retrieve and administer the shot. It is advisable that you leave your glucagon on your person, possibly in a backpack or handbag.
  • What if my child gets low at school?
    Highs and lows will happen at school, at home, and in many areas of your child’s life. Good diabetes management means responding quickly and calmly to correct blood sugar levels until they are back in target range. If your child is low at school, they should have access to a quick carb snack or glucose tablets or gel. Make sure your child’s teacher understands the need to have these supplies on hand and what to look for when your child is acting low. If your child loses consciousness, your child’s teacher or a responsive faculty member should have access to the child’s glucagon kit and be aware of how to give the injection. It is recommended that you review these steps with anyone who will be helping your child with their diabetes as a part of their T1D training.
  • What should I do during a test?
    By establishing a 504 plan with your school, patients are allowed special accommodations during Michigan state tests such as M-STEP/PSAT/SAT/ACT. If you need a snack, you are allowed to have one present during the exam. You may have permission to use a cell phone to monitor CGM values, but you must receive approval for all test accommodations with the test proctor and the school staff ahead of time. For certain tests, a letter from your clinician must be provided to the College Board in order to receive these accommodations. The College Board approval process may take up to 8 weeks, so be sure to plan ahead. A good reminder is to discuss standardized testing dates during the fall at the same time you are reviewing your 504 with the school. Please contact the clinic if you have questions about these issues.
  • How do I tell my friends about my diabetes?
    Talking about T1D with friends, family, and strangers can be difficult. Even if you are successful in managing your diabetes, it can be stressful discussing this personal information with new people in your life. JDRF offers a free PDF on how to talk about T1D with friends, family, coworkers, and in a variety of situations here.
  • Who needs to know about my child’s T1D at school?
    You and the school staff are partners in your child’s education and well-being. Strong and clear communication is crucial to the success of your child’s health. Staff you should consider educating about T1D include: Principal Nurse Guidance counselor Teachers P.E. teacher Latchkey / after-school program supervisors Cafeteria staff Coaches or extracurricular supervisors Bus drivers JDRF offers a free PDF that may help you in facilitating a relationship with your school here.
  • Are there scholarships for my college student with T1D?
    There are several scholarships just for teens with type 1! Click below to learn more about the College Diabetes Network (CDN) and other scholarship opportunities. College Diabetes Network (CDN) Diabetes Scholars Foundation Novo Nordisk Donnelly Awards (for teen tennis players with type 1) Seefred Trust Scholarship (Ohio residents only) ​Please note: These opportunities are typically open January-April. Check the Off to College (Teens) page for other opportunities.
  • How should I prepare for college life with T1D?
    Moving away from home with T1D can be a scary thought, but it is very possible to have a happy and healthy experience at college with T1D. To prepare you for this new chapter in your life, please check out our Off to College (Teens) and Off to College (Parents) pages. Please also feel free to check out College Diabetes Network's "Off to College" booklets on their website and request a physical copy in clinic.
Class Registration

Classes are held weekdays in the new Pediatric Diabetes Education Rooms 2386 & 2387, on Level 2 of the Taubman Center, inside the lobby where the Java Spot coffee shop is located, just outside the entrance to C.S. Mott Children's Hospital. Call (734) 764-5175 to register.

 

Cost & Insurance Information

Current rates are $68.00 per half hour for groups and $172.00 per half hour for individuals. Prices are subject to change and will depend on insurance coverage.

Before attending the diabetes education session, please call your insurance company to verify insurance coverage for diabetes education classes, clinic visits, and necessary lab work. Our prices are subject to change. Insurance coverage for the clinical care you receive from us varies depending on your benefit plan.  Please call us with any questions or concerns.

Diabetes Transition Program

Transitioning from pediatric care to adult care can be an intimidating prospect for many adolescents with diabetes and their families. Many of our patients have been with the U-M Pediatric Diabetes program for several years – some since infancy or toddlerhood – so working with a new diabetes team is understandably anxiety-provoking. Additionally, the prospect of transitioning out of being a part of the child’s day-to-day care can be a stressful experience for many parents. As parents, being involved in the transition process and getting familiar with the clinic that will be caring for their child, can help you better support your child during this critical time period.

 

Our Diabetes Transition Program was designed by passionate U-M pediatric and adult endocrinology team members with the goal of empowering young adults to transition into adult life successfully. It consists of a Transition Orientation followed by a Transition Clinic Visit (see below for more information).

If you are looking to transition to an endocrinologist closer to your home, you can use the American Diabetes Association (ADA) website to find endocrinology programs by zip code.

 

Transition Orientation

As part of the transition experience, patients attend a class with peers and adult endocrinology providers. The open-discussion format of the session covers topics including: living on your own with diabetes; college life and diabetes; staying safe and healthy; managing diabetes and social pressures such as alcohol, drugs, and sex; how to prevent diabetic ketoacidosis (DKA); diabetes and sick days; how to order diabetes supplies and communicate with insurance companies; and possible complications related to diabetes. Patients also receive an orientation to the U-M Metabolism, Endocrinology, and Diabetes (MEND) Adult Clinic.

 

Transition Clinic Visit

After attending the orientation class, patients are seen in the adult clinic for their transition visit. The U-M Pediatric Diabetes team works closely with the U-M MEND Adult Clinic team to help make the transition to adult care as seamless as possible.

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