Diabetes at the RCH

  • Our team is dedicated to helping you and your family manage your diabetes effectively so that you can lead a fulfilling and healthy life. For the patients and families of The Royal Children's Hospital (RCH),  this website provides guidelines for managing your diabetes at home. The purpose of these resources is to help you be independent with everyday management of diabetes such as dose adjustment, managing sick days and pump management.

    Being diagnosed with diabetes is something that can affect the whole family and there are many uncertainties and fears that can emerge with this. Here at the RCH, we have a large team of professionals that are here to help you. We care for infants, children and adolescents with all types of diabetes including

    • Type 1 diabetes
    • Type 2 diabetes
    • Cystic-Fibrosis related diabetes
    • Steroid induced diabetes
    • Rare genetic forms of diabetes

    Newly diagnosed type 1 diabetes

    All young people with type 1 diabetes require injected insulin. Having type 1 diabetes means you or your child cannot make enough insulin. Insulin doses are determined by blood glucose testing.

    As a patient of the RCH, you will meet with a diabetes dietitian, a diabetes social worker and a diabetes nurse educator who will teach you how to care for you or your child’s diabetes. It is very important that the adults who live and care for your child on a daily basis are available for these education sessions. 

    If you have been admitted outside usual business hours (after 4pm Monday to Friday or the weekend) the diabetes educator will come and see you as soon as possible the next working day. In the meantime the ward nurses will support you with your child’s diabetes care.

    At diagnosis you will have specific diabetes self-care skills to learn:

    • How to give insulin
    • How to do a blood glucose test with a lancing device/finger pricker
    • How to keep a blood glucose record book
    • What to do for a low blood glucose reading (hypoglycaemia)
    • What are ketones? When and why we test of ketones?
    • Diabetes and healthy eating

    Once home you will be in contact with a diabetes nurse educator for BGL reviews and adjustment of insulin. Your calls will reduce in frequency as you gain confidence in day to day diabetes management and you begin to alter the insulin based on the record book yourself. We will support you in this process.

    You may return for further outpatient appointments with the Diabetes Allied Health team in the days/weeks to follow to complete initial education. Your first doctor’s appointment should be booked about one–two months after diagnosis; you will also see a diabetes nurse and dietitian. Thereafter an appointment will occur every three–four months until your child transitions to an adult diabetes service.

    If you would like any further information, please call our diabetes office on 9345 6661 between 8am and 4pm Monday–Friday.

    2020 School Management Plans

    The Department of Education and Training (Victoria) require the Diabetes Victoria Diabetes Management Plan to be used in all early childhood education and care services, primary and secondary schools in the government, Catholic and Independent sectors in Victoria.  These management plans are based on current best practice evidence for diabetes care for young people with type 1 diabetes..

    To request a 2020 school or early childhood education management plan from a diabetes nurse educator please click here. Please note we require your 2020 grade level on the form and you must be an RCH patient. 

    Once the form is completed a DNE will complete the school plan for you and will post it to you in the mail. Please allow two weeks for this to occur. 

    To view the school plans as a blank PDF please click here to be taken to the Diabetes Victoria website where you can print and complete your own school plan to then be signed by your diabetes treating team.  

    Diabetes at school – online learning modules

    The Diabetes at School online education package has been developed by Diabetes Victoria, working together with the RCH and Monash Children’s hospitals.

    The package consists of three five-minute self-directed learning modules that can be easily accessed by all school staff. The modules help to ensure that all school staff understand type 1 diabetes and how it impacts on a student’s day to day life, are aware of Diabetes Action and Management plans and know how to respond appropriately to students experiencing hypoglycaemia and hyperglycaemia. There are also a number of resources available on this platform for staff wanting to deepen their knowledge of type 1 diabetes.

    You can access the online modules through the following link: https://diabetesatschool.com.au/. You will need to register as a school staff member or a parent/carer.

    From 1 July, 2020 Optisulin is the new name for Lantus insulin 

    Information on name change from Lantus (insulin glargine) to Optisulin (insulin glargine)

    There will be a change over period from 1 January, 2020 until the 30 June, 2020 where Lantus is still available. From 1 July, 2020 Lantus will be de-listed from the PBS and Optisulin will be prescribed by your endocrinologist in its place.   

    Federal Government Subsidy For Continuous Glucose Monitoring 

    On April 1 2017 the Federal Government announced that continuous glucose monitoring (CGM) would be fully subsidised for many children and young adults up to 21 years of age (Press Release). There is specific criteria for the subsidy to apply (Criteria), and many of our patients are  eligible. 

    The RCH has received a lot of interest in CGM from our families. In order to accommodate requests for CGM we have been able to employ an extra nurse to assist with the CGM starts.  

    • All CGM starts will be done in order of initial expression of interest or request.
    • CGM starts will happen through a day admission via the Day Medical Unit.
    • Most children will share their CGM start with another child. Children are matched to CGM device, insulin system and age (where possible).
    • Prior to an admission date for CGM, RCH sends the NDSS form to Canberra for processing. The time between faxing the NDSS for an approval can be up to 10 days.
    • NDSS then alerts the family and treating team to the approval. The device will then be sent by the supplier to the RCH. This can take up to two weeks from the time of approval.
    • When the device has arrived the RCH contacts the relevant family regarding a suitable time for the CGM start here at the RCH. We cannot advise a time until the device has already arrived because we have already had to delay some planned admissions as the device has not arrived in time.

    At this time we have been able to decrease our waitlist so that there is only a few weeks between applying for a CGM and your admission. If you have any questions about the timeframe please contact your diabetes nurse educator.  

    If you are unsure about what CGM is or does, please review the section of CGM on the type 1 diabetes page and watch at the webinars about CGM on the webinars page.

    If you would like to apply for a CGM and have a NDSS eligibility form, please email us via the details on our contact us page.

    Continuous Glucose Monitoring Initiative: FreeStyle Libre added and eligibility criteria streamlined from 1 March 2020 (Press Release)

    Privacy statement for diabetes technology

    Important information regarding the Terms and Conditions of your cloud based data.

    The RCH takes your private information very seriously. It is important when some technology is agreed as a treatment option, you have read and understood the relevant company’s terms and conditions of use.

    Almost all current diabetes technologies such as insulin pumps and continuous glucose monitors rely on cloud based technology to allow both the user, and the treating team to view the data. The ability to review this data, and share it with the treating team is vital to managing diabetes. It is very important that you are aware of how these companies manage your data. When you register to use the uploading or recording facility of the device, the company will ask you to agree to a series of terms and conditions. Within these terms and conditions are privacy statements about how the companies may use the data. For some systems, the RCH is required to agree on behalf of a user who is already registered. This is so we can see the data to provide clinical advice, but this does override the terms agreed to by the user at initial registration.

    There is no suggestion that any data is or has been used inappropriately, but we strongly recommend that families are aware of what is being agreed to by accepting terms and conditions.