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
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.
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.
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
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
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.
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
Parents will find this information helpful about healthy food for their growing child
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.
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
- www.nhs.uk/change4life/food-facts/food-labels
- www.bda.uk.com/resource/food-labelling-nutrition-information.html
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.
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
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If BG more than 11mmol/l or glycosuria (+/- ketonuria):
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- 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