Type 2 Diabetes Program

The Patient Experience

The Type 2 Diabetes Program at Children's Hospital Boston is part of the Optimal Weight for Life (OWL) Program. Together, we work with patients who have, or are at risk for, type 2 diabetes to educate them about the importance of nutrition and lifestyle choices.

In addition to the standard OWL Program evaluation and resources, patients with type 2 diabetes also receive appropriate diabetes education, diabetes-specific resource materials and diabetes health monitoring by pediatric endocrinologists.

Our team is a multi-specialty group, including attending physicians, registered dietitians, endocrine nurses, diabetes nurse educators, psychologists and social workers.

Medical evaluation

All new patients will be evaluated by a pediatric endocrinologist. This examination includes:

• a comprehensive personal and family history
• a physical examination
• laboratory tests
• diabetes education and management

The purpose of this evaluation is to identify any additional underlying medical conditions (such as a hormone problem) and potential complications (including high cholesterol or gastrointestinal disease).

Nutritional counseling

Dietary modification is the primary treatment used in the Type 2 Diabetes Program. Only under rare circumstances are weight-reducing medications considered.

Patients meet with staff to complete an analysis of their diet and are then given an individualized meal plan.

We frequently prescribe a "low glycemic index" diet to help stabilize changes in blood sugar after eating, thereby helping control excessive appetite. Other dietary approaches, such as a low-fat diet and a protein-sparing modified fast, are also available.

During the initial evaluation, families meet privately with a dietitian to discuss practical aspects of starting our recommended meal plan.

Behavior modification

Behavior modification focuses on increasing motivation to change diet and physical activity levels -- which can affect type 2 diabetes. We use a combination of short-term individual and family psychotherapy sessions. These treatments may also help children cope with the emotional stress associated with being overweight and/or having type 2 diabetes.

Research

Some patients in the Type 2 Diabetes Program and OWL program participate in research studies. You may be approached to participate in one of them. Your participation in any study is completely optional -- your decision will have no effect on the quality of care that you receive.