The Barts Health Children and Young Peoples Diabetes service is delivered across three sites; The Royal London, Whipps Cross University Hospital and Newham University Hospitals. Collectively we deliver diabetes care to around 600 patients.
Meet the team
Consultants at The Royal London: Dr Evelien Pease-Gevers (Clinical Lead), Dr Claire Hughes, Dr Rathi Prasad, Dr Ruben Willemsen
Consultants at Whipps Cross: Dr Paramita Cifelli, Dr Ashraf Gabr, Dr Prab Kalaivanan
Consultants at Newham General: Dr MalathiMala Kurre and Dr Ruben Willemsen, Dr Muriel Meso(Maternity Leave)
Lead Nurse Specialist - Paediatric Diabetes: Nicky Moor
Band 7, Clinical Nurse Specialists - Paediatric Diabetes: Lisa Fuller, Saniya Akther (Maternity Leave), Leah Thomas, Jenny Hurley (Newham University Hospital, ELFT)
Band 6, Paediatric Diabetes Specialist Nurses: Patricia Rogan, Freyja Cullen, Hannah Adamson.
Specialist Paediatric Diabetes Dietitians: Kate Sharples, Waseema Skogen, Chelsea Slough, Sarah O’Toole
Clinical Psychologist in Diabetes: Elizabeth Nash, Susie Gordon-Jones
Support staff: Margaret Murphy (Medical Secretary), Lucy Painter (Secretary, Royal London), Yasmin Khatun (Administrator and Database admin, Royal London), Shapla Ahmed (MDT coordinator, Royal London), Bianca Barnett (Admin Assistant, Newham), Abdul Latif (Pathway Co-ordinator, Newham),
Information for Families
Having a child newly diagnosed with Type 1 diabetes can be a very daunting time, we hope that when your child is diagnosed you are provided with all the information and skills you need to manage their condition. If you have any concerns or questions the diabetes team at Barts Health are available Monday - Friday via the nurses on call phone and via email. Out of hours each site has a way of getting emergancy advice 24 hours a day - see the contact us section.
Below are some additional resources you may find useful through your families diabetes journey:
- Digibete is an online resource providing video’s to support families with caring for their diabetes
- JDRF are an international charity who fund diabetes research focused on curing, treating and preventing Type 1 diabetes.
- Diabetes UK are an national charity that fund research and offer support for those with diabetes. Their website includes useful information for schools, parents, teenagers and young adults. There is useful infomation of how to complete the Disability Living Allowance form
- The book, Type 1 Diabetes in Children, Adolescent and Young Adults by Dr Ragnar Hanas is a detailed and useful resources if you want a deeper understanding of diabetes. It is a large book and covers all aspects of the research and knowledge about diabetes, to the practical management of diabetes, different life stages and practicalities. It is regularly updated with the latest research and developments.
- Carbs and Cals - We recommend using these apps to be able to accurately work out the carbohydrate content of your food.
- These are the Novo Nordisk Education Goals for children which we use during your annual review appointments.
- ISPAD is an international society whose aims are to promote clinical and basic science, research, education and advocacy in childhood and adolescent diabetes.
Companies that provide useful products and pump accessories
- Medical alert provide lots of different medical alert jewellery and ID tags
- Aquapac provide waterproof insulin pump cases
- Frio produce cooling pouches to prevent your insulin getting too warm on holiday or in hot weather
- IpSOX make insulin sock cases
- Funky pumps provide pump pouches and other diabetes products
- Spi-belt produce a small range of pump pouches
Helpful guides for pumps, glucose meters and devices
Downloading your meter
It is really useful to download your meters / pumps prior to clinic. We know that the more you look at your own data the better your diabetes management will be.
We do not get updates on when you upload your device. Please call 07889 591 637 or email us to let us know you have done this. We will usually have a look at the download and call you back.
If you use a blood glucose meter, Roche expert meter, Freestyle Libre, Omnipod or Roche Pump you can download to Diasend. Below are instructions on how to do this.
- Go to the diasend website (maybe save this in your favourites) and click on 'Register Here'
- Enter your email, enter personal details and then opt to share your data but entering the correct clinic code, depending on which hospital you attend to see your diabetes team
- Royal London - 62-29236
- Whipps Cross - 29-31999
- Newham - 39-66567
- Log in with your email and password
- Click on the tools tab
- Connect your meter or pump to the computer with a USB cable (Real time cable). It will upload to 100%
- Now when you go to the diasend website and log in, you should be able to look at your downloaded results
How do I get a cable?
If you are on a dexcom, Omnipod or Roche pump you should get a cable in your started pack. If you are on a Roche expert meter you will need to call Roche: 0800 731 22 91. Ask for a Roche Real Time Download cable, you should be given one for free.
Libre View is the online website. You need to log on and enter the practice code dependant on which hospital you attend. You can upload your Free Style Libre reader using the yellow cable that came in your start up box.
- Royal London – 14771901
- Whips Cross – 14149240
- Newham – 05610275
If you have a Smart phone with NSF technology you can download the Libre Link app, this allows you to swipe your phone over the Libre to look at your results. If you want to share this data with us, again you need to enter the above clinic code.
LibreLinkUp app is for parents / carers who’s child / young person has the Libre Link app to allow them to see when the young person has scanned and what their results are.
If you need help using your device you can contact us or Freestyle Libre website includes lots of handy video guides
Medtronic pumps can be uploaded using carelink personal website. You will need to log in and then download the carelink uploader software.
If you have issues call the Medtronic help line: 01923 205 167 or watch the video below:
Information for professionals
Do you suspect Diabetes?
Be aware that the characteristics of type 1 diabetes in children and young people include:
- Hyperglycaemia (random plasma glucose more than ≥11 mmol/litre)
- Weight loss
- Excessive tiredness
Refer children and young people with suspected type 1 diabetes immediately (on the same day) to a multidisciplinary Paediatric diabetes team with the competencies needed to confirm the diagnosis and to provide immediate care. There is no need to request a fasting blood glucose if a random glucose is ≥11 mmol/litre, or there is glycosuria or HbA1c >48 mmol/mol.
Referrals for new patients should be discussed with on-call consultant for paediatric diabetes and endocrinology or paediatric consultant of the week. Call the relevant hospital (Royal London, Whipps Cross or Newham University Hospital) switchboard. Send the young person directly to paediatric A&E.
- a fall across ≥1 weight centile spaces, if birth weight <9th centile
- a fall across ≥2 weight centile spaces, if birth weight between the 9th and 91st centiles
- a fall across ≥3 weight centile spaces, if birth weight ≥91st centile
- weight ≤0.4th centile for age, whatever the birth weight
- if the BMI is ≤0.4th centile (over 2 years old)
- Maximum of 2 food allergies
- Coelliac disease
We no longer accept referrals for overweight or obese children
- If child is overweight but BMI is below 3.5 SD - Please refer to health visitor/school nurse
- BMI Z score greater than 3.5 SD – GP to refer to RLH Paediatric Metabolic Obesity clinic
- Obesity with co-morbidities – GP to refer to RLH Paediatric Metabolic Obesity clinic
We do not accept referrals for simple iron deficiency anaemia or constipation. Please see useful infomation for families.
To be able to refer a child to the dietitians you will need to provide their weight, height and BMI with their centiles. View, download or order WHO growth charts.
Information for young people moving to adult services
If your diabetes team have started to talk to you about transition it means you have reached an exciting stage in your life. It’s a time of new beginnings, including friends, education or employment. You will be thinking about the future, independence and having more freedom to make your mind up about stuff.
This will also include your transition with your diabetes. Transition means getting ready to move from the paediatric diabetes service to the adult diabetes service. You will be invited to a new clinic with some familiar faces and new ones looking ahead with you and supporting you through these exciting times.
This video will tell you more about what this is about:
Will there be any changes to my care?
From the age of 14 you will have the opportunity to attend the first half of your clinic appointment on your own to talk to the diabetes team.
Legally, we will always need to see you with your parents up to the age of 16.
After you have turned 16, we can see you by yourself. Often, your parents would still be involved with your diabetes care and it is fine to bring them in if you would want to.
Ready Steady Go clinics
From 16, you will be offered to attend RSG clinics. The nurse and dietitian will talk to you about grown up issues and diabetes such as university, driving, alcohol and relationships etc.
It is a great opportunity for you to talk about how diabetes fits into your life and helping you to become independent.
Depending which clinic you attend your transition process will be slightly different:
Royal London Hospital
You can either move on to the adult diabetes team in Mile End Hospital or St. Bartholomew Hospital. From the age of 18 years you will meet the adult diabetes team in your usual paediatric diabetes clinic. We do these joint clinics a few times per year, so you can get to know the adult teams before you move on at 19 years old.
Newham University Hospital
We will see you in the teenager’s diabetes clinic from the age of 15 until 19. When you are ready to move on to the adult diabetes clinic we will have one joint appointment with the adult diabetes team to introduce you to them. The adult diabetes team has clinics in Shrewsbury Road.
Whipps Cross Hospital
Between the ages of 16-19 years you will continue to be seen in children’s outpatients with the familiar faces of the nurse and dietitian from the paediatric service plus a doctor from the adult service. When you are ready to move on you will go to the young person’s clinic at Whipps Cross Diabetes clinic.
Topics to explore as you prepare to transition
With all the life changes ahead of you, we will discuss topics to support your independence and ensure diabetes fits into your lifestyle and we will let you know where you can get more information from.
- Having a healthy diet and lifestyle
- Looking after your mental health
- Managing seeing your GP, medical team and picking up prescriptions
- Holidays and / or festivals
- Living independently
- Careers, university, college or work
- Relationships and family planning
- Tattoos and Body Piercings
- Puberty and Menstruation
- Alcohol, smoking and Drugs
- Personal Independence payment (PIP) and finances
There is a large online diabetes community which may help you feel more supported
- Twitter: @JDRF, @ninjabetic1, @BartsCYPDiab or search #T1D #Diabetes
- Youtube: Diabetes UK, #Type1uncut
Be careful with what you read online. Always consult your team prior to making any changes to your diabetes treatment.
Information for schools
Management of diabetes in schools training
The Barts Health CYP Diabetes team provide half-day sessions, aimed at anyone who has contact with a child or young person with Diabetes. They will be a combination of theory and practice and will aim to cover all aspects of diabetes including but not limited to: day-to-day management, management in school, food and carb counting, blood glucose testing, hypo’s and highs, injections, pumps, problem solving, school trips, legislation for schools and more.
12th March 2019
Bishop Challenor School
352 Commercial Rd, London E1 0LB
2nd April 2019
9.30am – 12.30pm
Mile end Hospital-
Mile End Hospital, Education Centre
21st May 2019
9.30am – 12.30pm
Whipps Cross Hospital –Education Centre
Whipps Cross University Hospital –
Education Centre, Seminar Room 1, E11 1NR
18th June 2019
9.30am – 12.30pm
Bishop Challenor School
352 Commercial Rd, London E1 0LB
9th July 2019
9.30am – 12.30pm
Calverton Primary School
King George Ave, London E16 3ET
School trips and residential trips
- Give parents/carers as much notice as possible so the trip can be planned in liaison with the Paediatric Diabetes team
- There is no reason why children/ YP with diabetes should not be able to go on residential trips, but staff will require further training regarding their daily diabetes regimes
- Activity holidays will need a change in insulin and food will need to be carb counted
- We provide personalized care plans for particularly active trips
- Contact the diabetes team for support with this
Diabetes UK has lots of resources online for school and for parents which can be accessed here. They asked children and young people to create videos about managing their diabetes in school. We really love them.
Research and networks
We work together with the clinical research facility to perform clinical trials in diabetes. We are currently involved in several clinical trials, including:
- ADDRESS2 (Database for patients with Type 1 Diabetes)
- CLOuD (Artificial Pancreas Study for patients with newly diagnosed Type 1 Diabetes)
- Trial Net (Follow up of family members of patients with Type 1 Diabetes)
- Sitagliptin in Type 2 Diabetes (Merck) (A study for new treatment in patients with Type 2 Diabetes between 10-18 yrs)
- INNODIA (An innovative approach towards understanding and arresting Type 1 Diabetes)
- T2NOW (Study of two oral diabetes drugs in patients with Type 2 Diabetes aged 10-18 years)
Networks we are part of
- Set up in 2010 the National Children and Young People’s Diabetes Network bring together 10 regional groups to support standardisation of care, sharing of good practice and maintaining high quality standards.
- Barts Health is part of the North East Thames group, part of the larger south East Coast and England region. There is also a Families with Diabetes National Network who provide a voice into the regional networks
- Set up in 2008, SWEET aims to improve secondary prevention, diagnosis and control of type 1 and type 2 diabetes in children and adolescence. The Royal London Hospital is a SWEET centre of reference
- European Reference Networks are virtual networks involving Reference Centres across Europe. They aim to tackle complex or rare medical diseases or conditions that require specialised treatment and a concentration of knowledge and resources. SWEET is one of these networks.
National Diabetes Audit Results 2017 - 2018
The National Paediatric Diabetes Audit (NPDA) is a national audit where each of the 170 children's diabetes unit in England and Wales has to submit data about the care of diabetes of the children in their unit to the Royal College of Paediatrics and Child Health. The results of the 2017-18 year has come out and these show that all 3 hospitals are doing well.
?The average HbA1c in the Royal London Hospital is much better than average; in fact we are top 10 in England and Wales! We and the Hospital's Chief Executive were sent a special letter to congratulate the unit. We also have more children on pump treatment than average, have more children that have their annual review and retinal screening completed although both are still well below 100%. We struggle to give everyone 4 HbA1c's per year and 4 appointments per year and we continue to try and work on that.
Newham Hospital improved so much that it was especially mentioned in the report, and their average HbA1c was well within the national normal range. The newest data for 2018-19 which we will be submitting soon shows even further improvement to the same high standard as in RLH.
The Hba1c in Whips Cross Hospital has always been good and remains good. The main struggle in Whipps Cross Hospital is to show data from the annual reviews and retinal screening so please make sure you get your blood and urine tests and eye test every year.
Tell us how we are doing
The National Paediatric Diabetes Audit is running Parent and Patient Reported Experience Measure (PREM) surveys to gain an understanding of parents’ and patients’ perspectives and experiences of the care they have that they have received in the previous six months. It will only take 5minutes, please click here to complete
We are improving
The whole Barts Health Paediatric Diabetes Team is taking part in the RCPCH quality improvement project. We have working groups improving our Newly diagnosed education for type 1 and type 2 diabetics. We are working on engaging with our families better and more. We want to ensure all our families get their annual key care processes. We are helping families to download their diabetes devices and interpret the readings. Our joint aim is to increase the number of our patients with an HbA1c of <48mmol/L as per NICE guidelines.