Our diabetes team is here to help guide you as you become comfortable learning more about your child’s diabetes condition and care needs. We offer educational materials that will help you through the learning process of day-to-day diabetes management at home.
We’re proud to be an American Diabetes Association recognized program with certified educators and to help patients and families navigate their journeys with type 1 and 2 diabetes. These services include education about taking your medicines, how to monitor blood sugar levels, healthy eating, treating high and low readings, preventing complications and coping with diabetes.
Diabetes education services are billed through insurance.
Download our comprehensive diabetes handbook
Diabetes is a condition that affects how your body turns food into energy. If you have diabetes your body either doesn’t make enough insulin (which acts like a key to let the blood sugar into your body to use as energy) or can’t use the insulin it makes as it should. Because of this, the level of sugar in your blood remains higher than normal, which can cause several health problems.
The two types of diabetes are type 1 and type 2. Both make blood sugar levels higher than normal but in different ways.
Type 1 diabetes: If you are diagnosed with type 1, also called juvenile diabetes, your pancreas does not make insulin. If you have type 1 diabetes, you will depend on daily treatments through insulin injections or an insulin pump to control blood glucose levels.
Type 2 diabetes: With type 2 diabetes, your body either resists the effects of insulin or does not produce enough insulin. While historically, type 2 diabetes has been referred to as adult-onset diabetes, more children are being diagnosed with type 2 diabetes and require diabetes management plans to help lose weight, eat well and exercise. If diet and exercise aren't enough to manage your blood sugar well, you may also need diabetes medications or insulin therapy.
For our families where it is uncertain if the diagnosis is type 1 or type 2 diabetes, we explain that the labs obtained while in the hospital will help to confirm a diagnosis, but explain that the only treatment at the time of hospitalization is the use of insulin.
The symptoms of type 1 or type 2 diabetes may include:
After the initial diagnosis, your child should be seen within one to two weeks, at one month and then at least every three months as needed for follow-up. Your initial follow-up appointments with your child’s provider will be scheduled prior to discharge from the hospital.
Follow up appointments are generally scheduled three months in advance. Please make future appointments as you are leaving your present appointment.
What to bring to appointments?
Prescription refillsRequest your prescription refills through the patient portal or by calling (804) 828-CHOR (2467) and follow the prompts for prescription refills. If you are leaving a message, be sure to include your pharmacy’s name, address and phone number and the medication and dosage.
Please allow three business days for refills. This allows us time to review your chart, which is necessary to ensure accurate refills.
For blood sugar between appointments, please send at least 7 days of blood sugar numbers, including insulin doses, via the patient portal (preferred method), fax or email. Logsheets are available in the resources and forms section of the guide.
Prior to an appointment: If your child’s technology is downloadable, please plan to do so from home, the day prior to the appointment.
If your child is using diabetes technology and you have completed a download, please advise the team so the data can be reviewed.
Always include your name, your child’s name and date of birth, and a daytime phone number where you can be reached.
Our team of diabetes educators will help you understand how to safely administer your child's medication doses based on your provider's recommendations.
You and your child are coached on how to monitor blood sugar using a glucose meter. You will go home with one meter and a prescription for a second meter, to ensure one can be left at school (if needed).
You and your child will be coached how to manage high and low glucose readings.
Hypoglycemia, or low blood sugar, is defined as a glucose reading less than 70 mg/dL (or less than 80 mg/dL, if your child is younger than 6 years old).
Hyperglycemia is defined as a glucose reading greater than 350 mg/dL.
Here are some usual signs of high blood sugar:
Signs and symptoms of DKA:
If blood sugar is greater than 350 or greater than 300 twice in a row one hour apart, dip ketone test strips into the child's urine and follow these steps.
The minimum amount of water recommended is 1 ounce/child’s year of age up to 16 ounces. For example:
Here are the parameters for blood ketone testing:
Without insulin, diabetic ketoacidosis (DKA) can occur, because the body cannot move sugar from the bloodstream into the cells. Ketones are dangerous and require treatment with appropriate medical therapy (including insulin).
When meeting with our diabetes team, we will review and outline how to properly monitor and treat your child’s blood sugars.
All children experience routine childhood colds or flu. While these illnesses usually aren’t serious, they can make diabetes management more challenging.
Call your on-call provider immediately if you notice the following:
The phone number to reach us for these urgent concerns is (804) 828-0951 and ask for: “On-call pediatric endocrinologist”
All children with diabetes can participate fully in physical education classes and team sports. To maintain blood glucose levels in target ranges, adjustments may need to be made to insulin and carb intake.
It’s also important to check blood glucose levels more frequently during times when your child is active to monitor for low blood sugars.
Important things to know about physical activity and diabetes
Our diabetes educators will help provide suggestions for safely exercising and answer any questions you may have.
Starting your child back to school after they’ve been diagnosed with diabetes can be stressful. Careful planning and preparation can help ease the transition for all involved.
To make this process as smooth as possible, here’s a list of the items needed for school:
Schools require an updated Diabetes Medical Management Plan (also called School Form) annually before starting a new school year. This form contains up-to-date medication orders and is usually kept by the school nurse.
Most schools will accept this plan on the standard form we provide. You will need to request a new form from us before a new school year.
Our team will help patients plan meals and snacks, provide tips for calculating a child’s carbohydrate intake, suggestions for low-carb snacks and more.
