Winter 2012

Clinic Offers Latest Advances in Diabetes Treatment

As advances in treatment offer type 1 diabetes patients improved quality of life, the trade-off is more complex management of a disease that has always placed relentless demands on young patients, their families and providers.

Dr. Saleh Adi with patient

Saleh Adi, M.D., director of the Madison Clinic for Pediatric Diabetes at UCSF, says, "The best care requires a dedicated, expert team to coordinate physical and mental health care, guide patient and family education, and integrate factors from the social environment."

Collaboration Essential

The Madison clinic exemplifies this approach and builds on UCSF’s international reputation for diabetes leadership:

  • Physicians weigh new types of insulin and monitoring and delivery technologies to make nuanced decisions about the best insulin regimen for a particular patient at a particular time.
  • Nurses, who are certified diabetes educators, coordinate the entire care process and tailor education to each family’s needs.
  • Patients and caregivers continually monitor glucose levels, and adjust insulin and diet accordingly.
  • Diabetes-trained dietitians educate patients and families about carbohydrate counting and optimization of dietary needs for a range of social and environmental situations.
  • Social workers assess the disease’s impact on family life and refer families to necessary resources.
  • A clinical psychologist — a rare, but important role, Adi says — provides guidance for coping with a disease that engenders high depression and burnout rates as well as difficult transitions to adolescence and young adulthood.

An Open Door for Patients

Having access to and understanding of the latest technology helps as well. Cutting-edge insulin pumps and sensors give the Madison clinic's team and their patients a full menu of disease management options. So do a host of clinical trials aimed at preventing and curing type 1 diabetes.

In the end, however, it is the close, open-door relationship with patients that makes the biggest difference. "Children change all the time, so we keep a channel open between us and patients, and make adjustments to their regimen as often as they need," Adi says.

Rather than adhere to standard quarterly appointments, UCSF patients come much more frequently when necessary. There are group meetings, phone check-ins, email exchanges and the ability to upload insulin pump data onto a dedicated server. The clinic also provides reports to patients’ community pediatricians after every visit. When the clinic moves to Mission Bay, Adi expects to pioneer telemedicine appointments and phone contacts via Skype.

"Managing this disease requires extreme dedication, and we live diabetes here," he says.

For more information, contact Dr. Saleh Adi at [email protected].

Madison Clinic for Pediatric Diabetes

In November 2011, the Madison Clinic for Pediatric Diabetes at UCSF opened its doors on the fourth floor of UCSF Medical Center at Parnassus. Director Saleh Adi, M.D., expects to transition to a brand-new facility at Mission Bay in September 2012.

Funded by a gift from a generous donor, the new facility — with a dedicated staff and front desk as well as ample parking — enables the diabetes team to see more patients and provide coordinated care in a single location for children, adolescents and young adults. That care includes programs such as the already established clinic for patients with celiac disease and type 1 diabetes.

"The new Madison clinic significantly expands the capacity of our pediatric diabetes program," Adi says.


Fall 2012 Table of Contents

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