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New Onset Outpatient Pediatrics Care at Joslin Helps Families with Diabetes Diagnosis

Friday, April 11, 2014

The onset of type 1 diabetes can be a difficult transition for children and their families. It can become more difficult if the children are hospitalized at onset. If type 1 diabetes is identified early enough, before any major problems arise, kids are often able to be treated in an outpatient setting, rather than having to be hospitalized. Joslin Diabetes Center piloted the New Onset Program in 2010 to make outpatient treatment possible and now it is fully available for all patients whose condition allows it.

Prior to the beginning of the New Onset Program, all Joslin pediatric patients were hospitalized at the onset of diabetes, even if their medical condition was stable.

“Outpatient management is often preferable because it is less disruptive to families and gives them immediate, real world experience in managing diabetes with the benefit of close supervision from an experienced team,” says Michelle Katz, M.D., M.P.H., an endocrinologist in the Pediatric, Adolescent and Young Adult Programs. She explains that the vast majority of patients can be safely managed as outpatients, with frequent outreach from the Joslin team to make the adjustment easier.

“Our first priority is always safety.  Some patients are very sick when they are first diagnosed with diabetes and they should be hospitalized.  For instance, if a child is persistently vomiting, they will likely require IV fluids and may even need intensive care,” notes Dr. Katz.

If a child has a stable medical condition at onset, outpatient treatment may be feasible. Additional criteria for outpatient treatment include if the family is comfortable with taking on the challenge of diabetes care and management immediately and the child is old enough, generally at least preschool age. The family cannot have any transportation barriers in coming to Joslin, such as living at a long distance and other related guidelines must be met.

You can get started in the Joslin New Onset Program with a referral from your child’s primary care physician. The first step in outpatient care is an initial assessment made over the phone, after which the child and family meet with a pediatric diabetes specialist.  Once a decision has been made that outpatient treatment is in fact a viable option, the child and family begin management and education programs guided by a multidisciplinary team.

“We have child life specialists to engage children in therapeutic play while their parents get the many hours of education needed to successfully manage diabetes at home. We also have two psychologists to work with children and families as they adjust to this new diagnosis and two nutritionists to support and educate families, in addition to the rest of the medical team,” Dr. Katz explains. The Joslin team helps families through the transition into diabetes management and supports them through their care.

Dr. Katz says that the program has been receiving positive feedback from both pediatricians and families and as word spreads, it is rapidly gaining popularity.  

For additional information on the New Onset Program or if you are a physician who wants to refer a patient, please call 617-732-2603.

Page last updated: October 24, 2014