Pediatric Diabetes

Many pediatricians rely on screening tests to diagnose children with diabetes.

Usually, this happens before children are referred to our clinic. Some of the common screening techniques include:

• A1C: This test measures your average blood glucose for the past couple of months. It doesn’t require you to fast or drink a special liquid. If you have an A1C greater than or equal to 6.5%, you will be diagnosed with diabetes.
• Fasting Plasma Glucose (FPG): This diagnostic test requires you to fast for at least eight hours before the test, so it’s usually done in the morning before you eat breakfast. An FPG will test your fasting blood glucose levels. If your levels are 126 mg/dl or higher, you will be diagnosed with diabetes.
• Random (Casual) Plasma Glucose Test: This is a blood test that can be done at any time. Doctors will often order this test for patients with severe diabetes symptoms. If the test reports a blood glucose of greater than or equal to 200 mg/dl, you will be diagnosed with diabetes.

If your child has been recently diagnosed with type 1 diabetes, you may feel shocked, confused or anxious.

This is normal. At Joslin, we’re here to help allay your fears and help you work through your next steps.

Children newly diagnosed with diabetes are treated safely and effectively at our Pediatric Clinic — and on an outpatient basis. Together, we’ll decide if outpatient care is right for your child by:

• Conducting a phone assessment.
• Determining if you’re ready to take on the management of diabetes care at home.
• Planning for your future visits to Joslin.

We’ll also schedule the first appointment when you and your child can meet with one of Joslin’s pediatric diabetes specialists.

Once your child has been diagnosed with diabetes and our team has done an initial assessment, we’ll craft a care plan based on their individual needs.

Our multidisciplinary team of specialists will meet regularly to review your child’s progress and continue to manage the disease. We’ve found that many of our patients see great success when we prescribe:

• Three to four visits to our clinic each year. This helps us keep track of your child’s progress and care.
• One or two visits with a dietitian. Helping your child choose to eat the right foods, at the right time, is a big part of managing diabetes.
• Regular visits with our family support team. This can help your child, and the whole family, adapt to living with diabetes.
• Three to four visits to our laboratory. Our child-friendly laboratory welcomes children and helps them through the lab work that’s required of diabetes patients.

In addition, we recommend meeting with a diabetes educator to talk through the daily management of diabetes. Our educators will cover:

• Monitoring blood sugar: We ask our patients to monitor and record their blood sugar throughout the day. This makes sure their blood sugar levels stay in check. We also offer regular A1C testing at our clinic.
• Insulin therapy: Many children with type 1 diabetes, as well as some children with type 2 diabetes, need insulin therapy. We offer a range of the latest insulin therapies, and your child’s doctor will work to find the right approach.
• Medication: Sometimes we prescribe oral or injected medications to support the pancreas and release insulin, or prevent the release of glucose from the liver. Your child’s doctor will explain available medication options.
• Nutrition counseling: Our team includes a registered dietitian who can prepare a specialized nutrition plan for you. Together, you can work together to understand the types of foods your child should eat, how much, and how often. We also provide support to help families manage both celiac disease and diabetes. We can recommend adjustments to your child's meal plan and techniques to cope with managing these conditions emotionally.
• Regular exercise: Fitness can help your child regulate blood sugar levels. Plus, exercise can boost energy and support mental well-being. An exercise physiologist will prescribe a realistic exercise plan that includes fun, child-friendly activities.
• Specialty care, when needed: We are in close proximity to some of Boston’s top hospitals and specialists. When needed, we partner with experts at Beth Israel Deaconess Medical Center for transplantation and other specialized care.

Joslin’s world-renowned Pediatric Endocrinology team works together to help children and teens manage diabetes, as well as other endocrine issues. We partner with our patients’ primary care physicians to provide:

• Medical consultations for complicated cases
• Second opinions on treatments
• Personalized evaluation and treatment plans
• Disease management and follow-up plans

Educating patients is a big part of what we do at Joslin. Our experienced nurse educators offer one-on-one consultations with patients, as well as group classes.

In our classes, we cover important topics, such as:

• The basics of diabetes
• Your first steps in living with diabetes
• Creating an exercise plan
• Healthy foods to eat
• How to use an insulin pump
• New technologies that treat diabetes

Our pediatric patients become lifelong members of the Joslin family. We work with them throughout their childhood and beyond to help keep their diabetes under control.

This starts with careful blood glucose monitoring — both throughout the day and through regular A1C testing. In addition, our dietitians and exercise physiologists also help you and your child learn about important lifestyle changes.

We strive to make our Pediatric Clinic a warm, welcoming environment. We’ve done everything possible to make sure your child can have fun, even at medical visits. In fact, many of our patients say they love visiting Joslin and seeing their favorite clinic team members, over and over.