MOUNTAIN STATES MEDICAL GROUP-PEDIATRIC ENDOCRINOLOGY Pediatric Diabetes Notebook TABLE OF CONTENTS GETTING STARTED FOOD Discharge checklist ......................................................................... 3 What are carbohydrates?............................................................38 Mountain States Medical Group-Endocrinology References .......................................................................................39 contact information ........................................................................4 Reading the food label ................................................................. 40 Phone call guidelines for newly diagnosed A handy guide to portion sizes .................................................. 41 patients with diabetes .................................................................... 5 What if I don’t have a nutrition label? .....................................42 Campus map and driving directions ...........................................6 Portion sizes for 15 grams of carbohydrates...........................43 Diabetes “survival skills” ............................................................... 7 Favorite foods reference guide .................................................. 44 Let’s plan some meals! ................................................................ 46 DIABETES BASICS Carb counting for recipes ........................................................... 48 What is diabetes..............................................................................8 I’m hungry….but it’s not meal or snack time ......................... 50 The difference between type 1 and type 2 diabetes ............. 10 Ideas for 10 gram snacks ..............................................................51 Diabetes basics ............................................................................... 11 Ideas for 15 gram snacks ..............................................................51 Keeping in balance .........................................................................12 Ideas for 30 gram snacks ............................................................52 45 gram breakfast ideas ..............................................................53 RECORDS 60 gram breakfast ideas ..............................................................54 Blood sugar log sheet ....................................................................13 45-60 gram lunch and dinner ideas .........................................55 Happy Holidays! ............................................................................57 BLOOD SUGAR MEASUREMENT What’s on your plate? ..................................................................58 Measuring blood sugar ................................................................ 18 The A1C blood test ........................................................................ 19 EXERCISE Diabetes routine (Lantus & Humalog/ Novolog before meals) .......... 20 Physical activity ............................................................................ 60 Diabetes care record ....................................................................22 Carbohydrate replacement for activity .....................................61 INSULIN RESOURCES Insulin products .............................................................................23 Taking diabetes to school ............................................................62 More about insulin ........................................................................24 Resources for people with diabetes ..........................................63 Basal bolus regimen ......................................................................25 Pharmacy list ................................................................................. 64 Directions for drawing a single dose of insulin ......................26 Diabetes and driving .....................................................................65 Directions for giving insulin ........................................................27 Traveling with diabetes ................................................................66 Tips for family coping ...................................................................67 LOW BLOOD SUGAR Top 10 diabetes self-management strategies ....................... 68 Low blood sugar (hypoglycemia) ..............................................28 Diabetes glossary ..........................................................................69 Glucagon injection ....................................................................... 30 Alcohol and diabetes ....................................................................74 Diabetes identification ..................................................................31 Drug use and diabetes .................................................................75 HIGH BLOOD SUGAR High blood sugar (hyperglycemia) ...........................................32 Ketones/DKA .................................................................................33 Urine ketones .................................................................................34 Pediatric sick day guidelines .......................................................36 Sick days for older children .........................................................37 PEDIATRIC DIABETES NOTEBOOK | Mountain States Medical Group-Pediatric Endocrinology | 423-431-4946 | 2 DISCHARGE AND FOLLOWUP CHECKLIST DISCHARGE CHECKLIST Finished “Survival Skill” education Check take-home supplies against list Glucagon emergency kit is packed Next dose of insulin is written on record form or phone contact arranged before dose time Diabetes school orders prepared and signed if necessary Set up phone contact with Dr. _______________________________________ FOLLOW UP APPOINTMENTS WHAT TO BRING TO APPOINTMENTS Physician follow-up appointment Blood glucose management records with _____________________________________ Meter(s), including school meter on _______________________________________ A list of questions First education follow-up appointment A list of supplies you need with _____________________________________ Diabetes Notebook on _______________________________________ Diabetes ID and treatment for low blood sugar Second education follow-up appointment with _____________________________________ on _______________________________________ PEDIATRIC DIABETES NOTEBOOK | Mountain States Medical Group-Pediatric Endocrinology | 423-431-4946 | 3 HOW TO CONTACT US MOUNTAIN STATES MEDICAL GROUP PLEASE NOTE: Prescription refills and routine blood PEDIATRIC ENDOCRINOLOGY sugar check-in should be completed during normal Located on the third floor of the 408 building business hours. behind Niswonger Children’s Hospital 408 N. State of Franklin Road, Suite 31B EMERGENCY & AFTER HOURS: Phone: 423-431-4946 Call Niswonger after hours on the nursing line: Fax: 423-431-4947 423-431-4946 WHEN YOU NEED HELP: OUR PEDIATRIC ENDOCRINOLOGY PROVIDERS Call Morgan Armentrout Diabetes Educator, • George Ford, MD, MS at 423-431-2370 during office hours, • Evan Los, MD Monday–Friday, 8:30 a.m. – 4:30 p.m. • Alexis Duty, MSN, FNP-BC HOW TO MAKE AN APPOINTMENT: • Morgan Armentrout, RN-BSN, CDE The clinic is open Monday – Friday, 8:30 a.m. – 4:30 p.m. Please call 423-431-4946 for current available days and times. PEDIATRIC DIABETES NOTEBOOK | Mountain States Medical Group-Pediatric Endocrinology | 423-431-4946 | 4 PHONE CALL GUIDELINES FOR NEW PATIENTS You have learned a lot about diabetes during your child’s hospitalization and will continue to learn more over the next several months with the help of your diabetes team. We will talk with you often by phone after leaving the hospital and follow up in clinic within 2-4 weeks. ROUTINE BLOOD SUGAR MANAGEMENT PHONE CALLS EMERGENT PHONE CALLS Initially, you will be asked to call the diabetes educator or nurse practitioner daily 9 a.m. – 12 p.m. EMERGENT PHONE CALLS to speak with a diabetes provider. The purpose There may be times when you will need to of these phone calls are to review blood sugars reach the diabetes team urgently. There is and adjust insulin doses as needed. If your child’s always a pediatric provider available 24-hours provider is not available, your call will be sent to a day including weekends and holidays for the on-call pediatric diabetes provider. You should emergencies. Times that you may need to reach expect a call back by the end of the day. If you have a diabetes provider urgently would include: not heard back by 5 p.m., please call and ask to speak with the on-call provider. • Advice for managing sick days • Positive urine ketones with illness or THE PROVIDER YOU WILL BE CALLING IS moderate to large ketones without illness MORGAN ARMENTROUT, RN-BSN, CDE. • Recurrent low blood sugar that does not correct with usual oral treatment** EDUCATION PHONE FOLLOW-UP • If your child will be out of insulin for the next A diabetes educator will contact you about one scheduled injection week after discharge from the hospital. We will answer questions and discuss concerns you may **IF YOUR CHILD IS EXPERIENCING A SEIZURE have regarding your child’s diabetes, prescriptions, DUE TO LOW BLOOD SUGAR, CALL 911 school issues, low blood sugar management and IMMEDIATELY! follow-up visits. These phone calls may continue until your child’s first follow-up appointment at the Diabetes Center. PEDIATRIC DIABETES NOTEBOOK | Mountain States Medical Group-Pediatric Endocrinology | 423-431-4946 | 5 AERIAL CAMPUS