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Intensive Management of Diabetes Locations Contact Information Request an Apppointment     Email This Page Print This Page           Intensive Management of Diabetes The Diabetes Program at Children’s National Medical Center actively supports intensive insulin regimens, including Basal/Bolus with injected insulin and insulin pump therapy. A physician recommendation or order is required before making this transition, so if you or your child is interested in making the change to intensive management, please discuss the possibility with your diabetes physician. Before making the change to intensive management there are a few things to consider: Carbohydrate counting is essential to successful intensive management. The patient and family must demonstrate the ability to count carbohydrates, not only foods that have food labels, but also common foods without food labels. This includes identifying the portion size, carbohydrate amounts, and measuring the food. Keeping a food diary may also be necessary. An appointment with our dietitian is required before attending a Basal/Bolus Class. Appointments with the dietitian are scheduled on an individual basis and can be made at Children’s main hospital, or at many of our Regional Outpatient Centers. Injected Basal/Bolus regimen requires one injection of basal insulin (Lantus) and an injection of rapid-acting insulin for all carbohydrate intake. During a typical day this means four or more injections per day, including one at lunchtime. This may require assistance at school if the child is not independent with insulin injection and/or calculating dosages. Basal/Bolus classes are held at Children’s main hospital every two to four weeks. A physician order is required before a patient may be scheduled for the four-hour class. Before a patient can be recommended for insulin pump therapy, the patient must have demonstrated successful Basal/Bolus management (with Lantus and rapid-acting insulin) for a minimum of four to six months. This prerequisite is necessary to learn the management skills necessary to be successful with insulin pump therapy. Children's holds monthly pump information nights so that children who have been recommended for insulin pump therapy can view all pumps and discuss features with pump company representatives. Children and their families are invited based only on recommendation by their physician and registration is required. At this time, insulin pump starts are done on an individual basis at the Children’s main hospital facility. For more information, to discuss your interest with a diabetes physician or contact Children's Division of Endocrinology call 202-476-2121.