Pediatric Endocrinology & Diabetes
Board-certified pediatric endocrinologists, a nurse practitioner, diabetes and endocrine nurse educators, registered dietitians, a child psychologist, and social worker will help you and your family determine the best treatment for your child.
More About Diabetes Care at Baystate Children's Hospital
Endocrine conditions we treat include:
- Adrenal disorders — such as congenital adrenal hyperplasia, Addison’s disease
- Disorders of calcium and vitamin D metabolism
- Diabetes, type 1 and type 2, CF related diabetes, MODY and others
- Growth disorders
- Lipid disorders
- Hypoglycemia
- Hypothalamic and pituitary dysfunction
- Metabolic bone disease
- Early and delayed puberty
- Variations in sexual development
- Thyroid dysfunction and thyroid nodules
Pediatric Diabetes Program
Our Pediatric Diabetes Program is accredited by American Association of Diabetes Educators and strives to provide exceptional care for children 0- 22 years old with all forms of diabetes, including:
- Type 1 diabetes
- Type 2 diabetes
- Prediabetes with A1c >6%
- Cystic fibrosis- related diabetes (CFRD)
- Maturity onset diabetes of the young (MODY)
- Neonatal diabetes
- Steroid induced diabetes.
Pediatric Cancer Survivorship Program
The pediatric endocrinology team works together with the pediatric cancer care team to provide education and care for your child's cancer diagnosis. We monitor for side effects and track of your child's growth and development after cancer treatment.
Pediatric and Adolescent Gender Health Program
In Baystate's Pediatric and Adolescent Gender Health Program, pediatric endocrinologists, a nurse practitioner, social worker and behavioral health specialists work together to offer comprehensive and compassionate care for gender diverse children and adolescents. Depending on your child's needs, we offer medical interventions to pause puberty and gender affirming hormone therapy (estrogen and testosterone). The timing of these interventions depends on several individualized factors that we will discuss with each family.
Contact us by calling 413-794-KIDS (5437)
Our normal office hours are 8 am to 5 pm Monday through Friday. Our team is available to address your urgent questions 24 hours a day, 7 days a week.
If you need to contact a provider outside of clinic times for an urgent issue, you may do so by calling 413-794-KIDS (5437). If you do not hear back from the on-call physician within 20 minutes, please call back.
Patient Portal
To access your child’s health information, message the care team, and request appointments and prescription refills, please sign up for the MyBaystate patient portal.
You can visit mybaystatehealth.org or download the free MyBaystate app on your cell phone. To sign up, create your own (not your child) username and password. If you are a Baystate patient yourself, follow the prompts to fill out a proxy form for your child. If you are not a Baystate patient, create your account and send back the attached proxy. Please note that access is limited for patients between the ages of 13-18. For patient portal support, call 413-322-4357 or email MyBaystate@baystatehealth.org.
Diabetes and Endocrine Emergencies
If you have an emergency that cannot and/or should not wait, such as your child is unresponsive or has serious medical emergency, call 911 or go to the nearest emergency department.
If you are not sure whether you need to go to the hospital, please call us:
- During clinic hours (8 am – 5 pm) call 413-794-5437 and ask to page your pediatric diabetes nurse educator.
- During evenings or weekends, call 413-794-5437 and ask to page the pediatric endocrinologist on call.
Examples of diabetes emergencies:
- Severe hypoglycemia
- Hyperglycemia with moderate or large ketones
- Vomiting child, unsure of insulin doses
- A crisis for which you need our immediate help or guidance
Example of endocrine emergencies:
- Your child with a diagnosis of adrenal insufficiency (Addison’s disease, hypopituitarism, congenital adrenal hyperplasia) develops fever or vomiting
Blood Sugar Review for Diabetes Patients
To contact us to review blood sugars due to new or persistent hypoglycemia or hyperglycemia, you have three options:
- Call our answering service at 413-794-5437. Leave a message that you would like to review blood sugar numbers and a nurse will call you back.
- Email us
- Fax to 413-794-7145
A nurse educator will review your blood sugars and we will call you back by the end of the day.
Prescription Refills
You can request prescription refills through the MyBaystate patient portal. Prescriptions will be sent to your preferred pharmacy. Please allow up to 48 hours to process refill requests. Please manage your supplies carefully as refill requests should not be made at night or on the weekends.
How to prepare
Diabetes visits rely heavily on information from pump and sensor downloads. This enables the care team to provide you with any necessary insulin regimen changes. Please download one day before your appointment so that our clinical staff will be best prepared for your appointment. It is also important that you take the time to review your device downloads prior to the scheduled appointment. This will allow you to be more involved in your care. If you are unable to download your meter, write down two weeks of blood sugars, take a picture of the log, and upload to the portal.
Downloading instructions
Here at Baystate Health, we are committed to offering you outstanding, person-centered diabetes care. As part of that goal, we use data from your diabetes devices to understand what is working in your care plan, what might not be working, and what could be changed.
Our hope is that this data will also make our visits efficient and effective — using our time for collaboration, discussion, and questions.
We have chosen Tidepool—a nonprofit organization founded by people with diabetes, caregivers, and healthcare providers—to view your diabetes data. It is a secure, web-based platform for uploading your diabetes device quickly and easily. Here’s what you will need to do in advance of our next appointment to get started with Tidepool.
- Ensure you have Google Chrome or Microsoft Edge installed as a browser on your computer.
- You should have received an invite in your email from Tidepool titled "Diabetes Clinic Follow Up - Claim Your Account". Please check your spam folder if you do not see this email in your inbox. Please follow the instructions in that email to claim your Tidepool account.
- Visit https://tidepool.org/uploadguides, identify your device(s), and follow the instructions within the guide to upload your diabetes data. If you are using your phone to connect with your Dexcom transmitter, please follow these steps to link your Dexcom account to Tidepool.
- If your device is not supported, please send a message to support@tidepool.org to document your request and contact us to discuss an alternative data upload method. If you have any questions at all, or run into trouble, please email support@tidepool.org right away so they can help you.
Visit the websites below for instructions on downloading your pump, CGM, or InPen.
Dexcom clarity
1-877-339-2664
If you use a phone as your receiver: Our team can email an invitation to share your child's Dexcom reports so we can access them. Please accept the invitation.
Freestyle Libre Flash CGM
1-855-786-4263
Medtronic carelink (pdf)
1-800-646-4633
To link to our clinic, call our office or go onto the portal to provide us with your carelink account username and password.
Tandem
1-877-801-6901
Omnipod
1-800-206-6601
To link to the clinic, please use code baystatepeds when prompted.
InPen
For help call 844-843-7903
Refer to your InPen app
What is Diabetes?
Type 1 Diabetes
Signs of diabetes in children include:
- Feeling unusually thirsty
- Urinating more often than usual
- Weight loss
- Fatigue
- Irritability
- Fruity smell on the breath
Type 1 diabetes is the most common type of diabetes found in children and young adults. This condition occurs when the body does not make enough insulin (a hormone made in the pancreas, an organ inside the abdomen).
Insulin allows the sugar to pass from the blood into the cells. There, it is burned for energy. The body cannot turn sugar into energy without insulin.
When insulin is not available, the sugar builds up on the blood and spills into the urine.
Type 2 Diabetes
When your body makes insulin but is unable to use it the right way to process sugar, you have type 2 diabetes.
Type 2 diabetes is more common in overweight, obese, and inactive pre-teens and teenagers.
If you have type 2 diabetes, exercising and managing your diet is very important.
How Do We Manage Diabetes?
Management of diabetes depends in part on the type of diabetes. Insulin is the only treatment for type 1 diabetes. When insulin is given, blood sugar levels decrease, and glucose can be used as energy to allow the body to function properly.
Insulin or other non insulin agents can be used to treat type 2 diabetes.
In general, diabetes is managed by:
- Checking your blood sugars
- Balancing your meals
- Exercising
- Adjusting insulin and other medication doses
Our Pediatric Diabetes Program is accredited by American Association of Diabetes Educators and strives to provide exceptional care for children 0- 22 years old with all forms of diabetes, including:
- Type 1 diabetes
- Type 2 diabetes
- Prediabetes
- Cystic fibrosis- related diabetes (CFRD)
- Maturity onset diabetes of the young (MODY)
- Neonatal diabetes
- Steroid induced diabetes
Diabetes Care & Management at Baystate Children's Hospital
A new diagnosis of diabetes can bring a family stress, worry, and other emotions. You are not alone. The Diabetes Care Team at Baystate Children's Hospital is here to care for your child and teach you and your family all you need to know about managing diabetes. We care for over 700 children and families with diabetes in the western Massachusetts region.First we’ll work with you and your child to diagnose the condition. Then, we’ll begin care right away, providing intensive therapy on an outpatient basis whenever possible. We work closely with you and your child to prevent complications. Our team of specialists also provides training to help you and your child successfully manage diabetes at home and school, with age-appropriate instructions for your child
If you're concerned that your child may have diabetes, talk to your primary pediatrician, who can refer you to the pediatric endocrinology team.
What to Expect After Diagnosis
Here is an overview of what to expect in the first few weeks after your child is diagnosed with diabetes:
- Two or three separate but detailed teaching visits within the first few days of diagnosis, providing essential information and creating a care plan specific for your child and his/her
needs - A visit one week later for medical management and increased nutrition education and support
- Follow up visit about 2 weeks later to review blood sugars and labs drawn at diagnosis
- Follow up visit 1 month later
- Routine visits for medical management and nutrition every 3 months
- Please plan for 4 hour visits initially.
- Please plan for intensive support via phone for the first couple weeks, contact information will be exchanged at the initial meeting
How to prepare for your visits:
- Please pack snacks, meals, and water for you and your child. We do not have dining accommodations on-site.
- Please make necessary child care arrangements for your other children prior to your visit.
- We will take the time you need to teach the skills and essential know-how needed for caring for your child with diabetes.
Diabetes Nurse Educators: Diabetes Nurse Educators are registered nurses (RNs) who specializes in teaching families how to care for a child who has been diagnosed with diabetes. You will be spending many hours with your primary diabetes nurse educator to learn the management of your child’s diabetes. The nurse educator will continue to teach and support you in the diabetes program in person as well as through frequent telephone calls. Routine contact will focus on reviewing blood sugar numbers and insulin doses after blood sugars have stabilized and will become a consistent part of your child’s care.
Registered Dietitian: A dietitian is a food and nutrition expert who will meet with you during the first week to develop an individualized nutrition plan of care. She will teach you the skill of carbohydrate counting and provide you with tools that will help you and your family to make healthy lifestyle choices. She will follow your progress and is available to meet with you as needed as your child grows.
Pediatric Endocrinologist: A Pediatric Endocrinologist is a physician who specializes in treating children with diabetes as well as other conditions affecting growth and pubertal development. The Pediatric Endocrinologist will assist the educator at each visit in reviewing blood sugar numbers, adjusting insulin doses, and providing medical oversight.
Child Life: The Child Life Specialist (CLS) is a trained professional with expertise in helping children and their families overcome life’s most challenging events. With a background in child development and family systems, the CLS promotes effective coping through education, preparation and medical play. The CLS may help in assessing your child’s understanding of diagnosis, clearing up common misconceptions, providing developmentally appropriate recommendations for language and self-expression activities or opportunities.
Social Work: Clinical Social Workers are trained and licensed professionals who have expertise in support and resources. When you're diagnosed, they will interview your and your child to get to know you and your family situation. It’s about helping solve basic issues with daycare providers, school systems, employers, and insurers. It’s about helping you build a supportive network. Diabetes is more than a diagnosis for one child – it affects entire the family. You will gain new knowledge and experience new demands and feelings. The Social Worker can listen, guide, and support you along the way.
Medical Assistant: Medical assistants are vital members of our team. They prepare your child for their appointment by obtaining your child’s vital signs and medical history. They assist in downloading your child’s blood glucose meter and insulin pump as well as coordinate additional appointments or tests. They are cross trained in administrative and clinical tasks to help the department run smoothly.
Behavioral Health: Our behavioral health specialists help our families deal with natural emotions such as stress, sadness, anger, and denial which can lead to depression. The mental management of diabetes is just as important as the medical management. You will be offered the opportunity to meet with our behavioral health team.
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