Paediatric Diabetes service (East)

Exeter Children and Young Persons’ Diabetes Service (ExCYPDS)

The most common type of diabetes in children is type 1 diabetes. This is a lifelong condition where the body's immune system attacks and destroys the cells that produce insulin. This causes blood glucose (sugar) levels to become too high. The treatment for type 1 diabetes includes glucose monitoring via a sensor, a healthy diet and insulin therapy in the form of injections or continuous insulin infusion (via a pump).

Other types of diabetes are also supported by the team include

  • Type 2 diabetes – where the body does not produce enough insulin, or the body's cells do not react to insulin produced. A healthy lifestyle is vital in these cases with increased exercise and a healthy diet. A number of other medical treatments maybe required such as oral or injected medications.
  • Cystic Fibrosis related diabetes – Cystic Fibrosis is an inherited condition that causes a build-up of thick mucus in the lungs and other parts of the body. Glucose levels may rise because of this and glucose monitoring and/or insulin therapy may be required.
  • Monogenic diabetes – there are a number of genetic forms of diabetes such as maturity onset diabetes of the young, neonatal diabetes and other rare forms. A number of other medical treatments maybe required such as oral or injected medications.

The Exeter Children and Young People’s Diabetes Service provides care for children aged up to 19 years old with all types of diabetes.

Treatments

As well as insulin treatment, we support and educate all our patients and their families to help them manage their long-term condition. The team provide wrap around care with telephone access to a paediatric specialist 24 hours a day. Advice and education to families is provided in the hospital at diagnosis, at home and via remote means (telephone, text, email and video consultations). The young person with diabetes is always at the centre of our team.

The Paediatric Diabetes Specialist Nursing team teach the practicalities of managing diabetes day to day. The needs of each child and family are different and the team use a range of available technologies to support their bespoke diabetes management. We follow national and local guidelines and criteria when initiating treatment options.

The whole team take part in reviewing treatment plans regularly with the family and changes are required frequently as young people grow and develop. Families are encouraged to use multiple technologies to support their diabetes management and these are downloaded into shared computer systems for review and analysis.

Diabetes Psychology

Diabetes is a burden on all our families. Our Diabetes Psychologist is a vital member of our team, helping families with thoughts and feelings about living with a long-term condition as well as targeted support for managing difficult procedures and treatments. Our psychologist also supports the team with education and training such as our popular Tree of Life session for those young people in year 6 transition point to secondary school.

Contact us

If you want to get in touch with the department, please contact:

Urgent enquiries

If your child is acutely unwell please call NHS 111 and ask for advice or 999 if an emergency.

To speak with a member of the paediatric diabetes team call 01392 411611 9am – 5pm Monday – Friday your call will be directed to the PDSN team answerphone. The call will be directed to the Paediatric Registrar from 5pm – 9am. At the weekends your call will be directed to the PDSN or Doctor on call.

Non-urgent enquiries 

Non-urgent messages can be left on 01392 403727 between 9am – 5pm on working days and non-urgent emails via rduh.paediatricdiabetes@nhs.net the PDSN aim to answer these within 32 hours

Non-urgent direct contact with Dietitian 07827239019 or maria.leveridge@nhs.net

Where to find us

The Paediatric Diabetes Specialist Nurse Office, Room J158 on level 1 of template J, Paediatric Outpatients at Wonford Hospital.

This base is always not manned and we advise arranging with a member of the team before dropping in.

Our team

Lead Consultant

  • Dr Chris Moudiotis, Consultant Paediatrician in Diabetes & Endocrinology, Clinical Lead for Exeter CYP Diabetes Service

Consultant

  • Dr David McGregor, Consultant Paediatrician, Clinical Lead for Neonatology

Doctor

  • Dr Sue Hellewell, Speciality Doctor Paediatrics and Paediatric Diabetes

Paediatric Diabetes Specialist Nurses (PDSN)

Lead PDSN

  • Heather Fisher

PDSN/PDN

  • Ruth Dalton
  • Emm Greenslade
  • Becca Glover
  • Sean Lambert
  • Rosa Mai Sell

Paediatric Diabetes Specialist Dietitian

  • Maria Leveridge

Paediatric Psychologist

  • Dr Rosie Orchard (commencing October 2024)

Administrators

  • Natty Barlow
  • Emma Black

Clinics

Paediatric Diabetes clinic

Wonford Hospital, Barrack Road, Paediatric Outpatients, area J, level 1

Clinics occur on Tuesday and Thursday afternoons most weeks. We see young people up to the age of 16 years old in this venue. www.royaldevon.nhs.uk/our-sites/royal-devon-and-exeter-hospital-wonford

Young Persons’ Diabetes Clinic

The MacLeod Centre is at the Wonford Hospital site in a separate building at the corner of Barrack Road and Haldon View Terrace.

Young people over the age of 16 will be seen at the Centre by the paediatric diabetes team. Clinics occur on the second Thursday of the month in the afternoon. www.royaldevon.nhs.uk/our-sites/macleod-diabetes-and-endocrine-centre

Transition to adult services

The service also provides young people with diabetes with bespoke education and support as they move on through to adult care. This transition process commences at the age of 12 years old and we support young people though to independence with their diabetes care. We use the Ready, Steady Go (Southampton) model to frame our discussions with families. Young people do well when parents and carers remain involved in their care throughout their transition to adulthood.

www.uhs.nhs.uk/OurServices/Childhealth/TransitiontoadultcareReadySteadyGo/Transitiontoadultcare.aspx

www.readysteadygo.net/rsg.html

Supporting you

Peer support is vital for families living with diabetes. The team recommend families join local and national parent support groups.

Parent led support group in our area

Snack Pack, Diabetes UK affiliated group

exeter-children-s-snack-pack.diabetesukgroup.org

South West Families with Diabetes Group

There is a national parent led support group for families with diabetes linked to the National Children and Young People (CYP) Diabetes Network. This Patient/Parent/Carer reference group was set up to allow direct influence from those using the paediatric centres to feed into the national agenda.

www.facebook.com/groups/351695801609372

Patient information leaflets

We produce a wide range of leaflets which provide information about our services and about the treatment you might receive in our clinics or during your stay in hospital. 

We also produce these in different formats including large print, please contact the department you are visiting for more information.

Find out more

Community services

The team provide training, education, individual healthcare plans and telephone support to the wider team supporting the child and family. This can include extended family, all nursery, school or college settings, youth workers, voluntary and social care sector. The dietitian will support with carbohydrate counting menus for young people in these establishments.

Schools

The PDSN team provide advice and training for schools, nurseries and colleges.

www.diabetes.org.uk/guide-to-diabetes/your-child-and-diabetes/schools

Training programme for school staff

jdrf.org.uk/for-professionals/school-pack/schools-e-learning-module

ISPAD Position Statement on Type 1 Diabetes in Schools

www.ispad.org/news/420540/ISPAD-Position-S

Useful videos

DigiBete website includes a number of practical videos for diabetes treatment, advice on a range of topics about diabetes for different age groups, access to research presentations on future technologies and advances in treatment

www.digibete.org

We ask our families to carbohydrate count when they have type 1 diabetes. Here are some links to useful videos on carbohydrate counting from the Sheffield Diabetes Dietitians

Useful websites

Juvenile Diabetes Research Foundation – JDRF

JDRF is part of a global network of charities to inform and promote research for type 1 diabetes. They raise funds for research, plus provide family days, educational and experience days as well has having a useful website of resources.

jdrf.org.uk

Diabetes UK

Diabetes UK is a charitable organisation that provides help, support and advice for all ages of people with type 1 and type 2 diabetes. It also funds research into diabetes treatments and potential cure and prevention.

www.diabetes.org.uk/guide-to-diabetes/your-child-and-diabetes

Food and Diabetes

Here are some useful websites for young people to learn more about healthy foods to include in your diet

www.nhs.uk/change4life

www.greatgrubclub.com

Parents will find this information helpful about healthy food for their growing child

www.cwt.org.uk

www.nutrition.org.uk/nutrition-for/children

www.bda.uk.com/resource/healthy-eating-for-children.html

Useful apps

General diabetes information

DigiBete App - contains information on the ExCYPDS team, news items and further diabetes care and treatment links. The clinic code is available from your diabetes team.

www.digibete.org/digibete-app

Food Apps

Nutra Check App – free app for looking up nutritional values of foods (use bar code or search)

Carbs and Cals App – Carbohydrate estimation app, requires a monthly subscription

Samsung Food App – save recipes using the url. Basic nutrition information per portion can help with carb counting

Reading food labels

Carbohydrate counting estimation tool

Extending knowledge beyond carbohydrates

More about us

The team actively participate in national diabetes audits of care, quality assurance initiatives, patient experience surveys, research and attend regular education meetings with the local paediatric diabetes network and at a national level. All the team participate in education of other non-specialist health care professionals who may encounter young people with type 1 diabetes in their care.

National Paediatric Diabetes Audits (NPDA)

More about this team and their performance can be found at the Royal College of Paediatrics and Child Health website.

www.rcpch.ac.uk/work-we-do/quality-improvement-patient-safety/national-paediatric-diabetes-audit

National Children and Young People (CYP) Diabetes Network

10 regional CYP diabetes networks in England plus the Wales CYP Diabetes Network together form the National CYP Diabetes Network. Their aim is to share good practice and maintain high quality standards for all young people with diabetes.

www.cypdiabetesnetwork.nhs.uk

Information for healthcare professionals

All young people with suspected type 1 diabetes should be referred to the hospital emergency department for same day admission. Please see the following guidance

northeast.devonformularyguidance.nhs.uk/referral-guidance/northern-locality/paediatrics/diabetes

If BG more than 11mmol/l or glycosuria (+/- ketonuria):

  • Refer immediately (same day) to the acute paediatrics on-call team
  • Inform child and family of the suspected diagnosis of diabetes
  • British Society for Paediatric Endocrinology and Diabetes (BSPED). UK guidance for all aspects of diabetes care for children and young people bsped.org.uk
  • Association of British Children’s Diabetes Clinicians (ACDC). UK guidance for all aspects of diabetes care for children and young people a-c-d-c.org/endorsed-guidelines
  • International Society Pediatric and Adolescent Diabetes (ISPAD). Guidance for all aspects of diabetes care for children and young peopleispad.org
  • National Institute Clinical Excellence (NICE) Guidance for children and young people with type 1 and 1 diabetes nice.org.uk/guidance/ng18
  • Guidance on other types of diabetes (monogenic and neonatal diabetes) diabetesgenes.org

Last updated: August 09, 2024.