Information for Patients and Families

Welcome to the Paediatric Diabetes Education Centre

Whether you or your child are newly diagnosed, or you are already a patient, we hope that you’ll find helpful information on this site. Please contact us if you have a question that is not answered here – we are here to help.

What we do

Our program includes individual teaching, counselling and support for children and teens with diabetes, their families and/or caregivers. We support numerous families in our program, with many children using either multiple daily injections (needles) or insulin pumps to manage their blood sugars. We support the whole health of our clients, which includes emotional and mental health in addition to physical health. We help you manage your diabetes well and to follow Diabetes Canada’s guidelines. We are able to test HbA1c (90-day average blood sugar) onsite and are a certified Assistive Devices Program (ADP) centre that will help you to receive government funding to cover most of the cost of insulin pump supplies.

Who we are

The clinical team includes paediatricians specialised in providing diabetes care, registered nurses, registered dietitians, registered social workers, a child life specialist and administrative staff. Some members of the clinical team are certified diabetes educators. When you join our clinic as a patient family, the person with diabetes will be followed by one particular physician and will get to know the rest of the team. All of us together with the patient at the heart, form a medical team to partner with the family to provide diabetes care.

Have you or your child just been diagnosed?

Your family is starting a journey that will include many changes both now and as you/your child grows to be a healthy, responsible young adult. Our team is here to assist you and your family through the many ages and stages of diabetes management. Our goal is to guide you in achieving everything that a full life includes for you and your family.

What you can expect from our team
We will do our best to:

• Provide you with timely access to high quality care in a safe and comfortable environment
• Share meaningful information about your/your child’s plan of care so you can make informed decisions
• Involve you/your child and those most important to you in your care
• Listen and respond to you/your child’s needs in order to build a trusting relationship
• Care for you/your child with respect, compassion and dignity

Our clinic's expectations
We ask that you do your best to:

• Provide us with information important to your/your child’s care in a timely manner
• Respect the team by attending appointments on time and cancelling in advance whenever possible to allow for appointments to be offered to other families in need if you cannot make it
• Be honest with your struggles and celebrate your successes

Newly diagnosed patients will first be seen by the doctor and diabetes educator. You will then receive new patient teaching, consisting of 3 registered dietitian, 2 registered nurse and one registered social worker appointments. We try our best to minimize the number of different days you need to come to the clinic and take time off of work/school, so we will try to schedule two appointments on the same day when possible. You will be in daily contact with the doctor for the first week or more, after which you will be able to speak to an educator during the business hours.

About a month after diagnosis, you will come to the clinic for follow up, then will be expected to attend appointments every three months for routine care. This may be every six months in the case of pre-diabetes or Type 2 diabetes. The team is available to you in between these routine appointments for help along the way.

When you attend for a clinic visit, please make sure you that bring the child’s OHIP card (or other health insurance form, such as Interim Federal Health) to the reception desk to sign in. Please also bring downloads from any monitoring device that you are using (glucometer, sensor) or send it in advance if possible (upload, send in a pdf file, share access to the data, etc.). The person with diabetes is expected to attend appointments unless otherwise discussed and agreed upon with the clinic team.

Topics covered at diagnosis include immediate “diabetes survival skills” where families learn the basic skills of managing diabetes. Family members, close friends or caregivers are welcome to join you at any appointment.

Topics we will cover over the first few weeks include:

• How to test your blood sugar: we will provide you with a blood glucose meter, a prescription for test strips, as well as a demonstration of use and time to practice
• How insulin/your prescribed medication work(s) and how to take it: please bring your diabetes medication(s) to the appointment
• How food affects your blood sugar: how to keep eating all the foods you love
• The benefit of exercise and how to safely participate in all activities
• What to do when you're sick or feeling unwell
• Adjusting and coping with the new diagnosis
• Working with the school (helping arrange a school nurse if needed, making plans for self-management during the day, helping school staff get educated on diabetes, etc.)

After initial education, your clinic visits will be a minimum of once every 3 months with the diabetes team (nurse, dietitian, social worker and physician). You can expect each clinic visit to be up to 1½ hours in length from your scheduled appointment time.

• You will have access to your nurse and dietitian educators Monday to Friday (excluding holidays) from 8:00 am to 4:00 pm via appointment, telephone and virtually via video call
• The Insulin Adjustment and Illness Support Hotline is available during the week and messages left before NOON will be returned the same day; messages left after will be responded to by the end of the next business day
• Our social workers and child life specialist are available by appointment, telephone and virtual sessions
• Annual check-ins regarding adjustment and coping with diabetes are an essential part of your/your child’s visit

Resources will be provided, as well as contact information for the team so you feel continuously supported and connected.

Virtual appointments may be available at the discretion of the clinical team.

Safe Disposal of Diabetes Supplies

There are many diabetes supplies that you will become used to using. It is very important to manage the safe disposal of your supplies.

• Supplies that poke (needles, lancing devices or “finger pokers” and sensor and pump infusion site inserters) all need to be disposed of in appropriate sharps containers. Sharps containers are available for free from many pharmacies. (ewswa.org) Another place to dispose of these items is your local municipal sharps disposal.
• Refillable and disposable insulin pens go into the garbage.
• Test strips should be placed in the regular garbage.
• Glucometers can be recycled through some pharmacies or biomedical waste in the municipal landfill.
• Sensors: Applicators go into sharps containers, plastic wrap and paper can and should be recycled, but there may be local variation depending on recycling facilities. The plastic cannula, sensor filament, oval tapes after use can be thrown in the garbage.
• Pump Supplies: some pump supplies, such as Omnipod pods, can be recycled through the manufacturer’s programs; boxes, manuals, guidebooks and information guides are all recyclable. The infusion set left overs that contain needles need to go into the sharps container. Tubing with sharps need to go into the sharps container.

Insulin Pump Program

Our clinic supports children and youth in managing their diabetes through a variety of treatment methods, including insulin pump therapy (typically for patients who have Type 1 diabetes). Three main insulin pumps are used in the paediatric population in Ontario: Insulet Omnipod, Medtronic and Tandem. Most children and youth receive funding through the Ontario government's Assistive Devices Program (ADP) and/or caregiver extended health insurance. When you and your child are interested and ready, our team will complete an assessment to review the criteria for funding and to prepare you and your child for pump therapy. We have a pump readiness process that helps you to be successful in making the change from injections to pumping. Our team members are certified pump trainers and highly skilled with the various pumps available in Ontario.

Use of Sensor Technology

Many children and youth who have diabetes choose to monitor their blood sugars using sensor technology. The current technology of real time continuous glucose monitoring (rtCGM) is available to those who wish to wear the sensor. There are three sensors makes available: Abbott Freestyle Libre, Dexcom and Medtronic. Our team is trained in the use of all rtCGM systems. We are happy to help answer any questions you might have about insulin pump therapy, continuous glucose monitoring, as well as funding options. Currently there are some government funding limitations for rtCGM sensor augmented pump therapy.

Transition to Adult Diabetes Care

Whenever possible, preparing for transition to adult care begins in early high school. Our team will endeavour to provide age and stage appropriate education to prepare you/your child to gradually increase knowledge, independence and competence in managing diabetes within individual comfort level and capacity. We believe that taking a team approach to diabetes management is lifelong, and that parental/caregiver involvement and the division of responsibility occurs over time and with the involvement of all interested parties. Transition topics build on basic knowledge that we hope is shared amongst family members and also reinforced at home.

The transition program will cover topics such as:

• Growing up with diabetes
• Understanding and taking responsibility for taking care of your diabetes
• Coping skills, mental health well being
• School challenges and transitions from elementary school to high school, and high school to postsecondary studies, a gap year or the work force
• Insurance and how to pay for supplies
• Personal matters: relationships, alcohol and drugs, personal health
• Driving with diabetes
• Choosing an adult program, and what to expect in adult care

Links, videos and useful information

Please note the list below is meant for informational and resource purposes only. Those organizations are responsible for the information contained within their sites and any comments regarding these sites should be directed to that individual organization. Trillium Health Partners does not approve or endorse the content on any third-party Web sites. These links are strictly provided as a convenience to you for additional information. Trillium Health Partners is not responsible for the content of linked third-party sites or third-party advertisements and does not make any representations regarding their content or accuracy. Your use of third-party Web sites is at your own risk and subject to the terms and conditions of use for such sites.

Contact Us:

Phone: 905-848-7653
Fax: 905-804-7741

Insulin Adjustment and Illness Support Hotline: #905-848-7176 or PDET@thp.ca

We are open from Monday to Friday from 8am to 4pm.

The clinic is closed on statutory holidays. Please go to your local emergency department if you are concerned.

Paid surface parking is available at the back of 77 Queensway West. There is a free 10-minute drop-off period. Underground parking is available in the neighbouring buildings at 89 and 101 Queensway West. We are located across the street from Trillium Health Partners Mississauga Hospital Emergency Department.