There will come a point – usually around age 16 to 18 – when as a young person with diabetes, you will make the move from childhood medical support services and specialists to adult medical care.
- We offer several clinics that focus on the care of 16 to 25 year olds with type 1 or type 2 diabetes
- Clinic staff such as diabetes nurse educators and dietitians are from both the Royal Melbourne Hospital (RMH) and the Royal Children’s Hospital
What we do
Transitioning to adult care is a big step and it can be quite daunting to leave behind the team that you may have known and trusted for many years. One of the biggest differences between child and adult health services is the independence that you will gain. But at the same time, you will be expected to learn how to manage and take control of your diabetes yourself.
If you are transitioning to our Young Adults with Diabetes Service (YADS) at the RMH, we hope that the following information answers some of your questions and helps to reassure you that coming to the ‘big people's’ clinic is nothing to worry about. In fact, it’s a friendly place and provides you with the opportunity to meet other young people with diabetes.
Our fantastic team will also do their best to assist you to gain the skills needed to manage your diabetes.
YADS clinics are designed specifically for young people with diabetes who are aged between 18 and 25 years.
The clinic is located in 1 Centre. From the main lift foyer, take the stairs or lift to the first floor. On arrival, please check in at reception.
Once you have checked in (and before you see the doctor), we would like you to go to Royal Melbourne Hospital Pathology to have an HbA1c test. This is done via a simple finger prick test. The result will be given to you immediately, so you can bring it with you to your appointment. You are not required to pay for the test; it will be bulk billed using your Medicare card.
From the main lifts on the ground floor, follow the blue line to Melbourne Private and the RMH car park. The Royal Melbourne Hospital Pathology is located on your right, just before the car park.
Once you have your HbA1c result, follow the blue line back to the main lifts and take the stairs or lift back to the first floor.
We’d like the opportunity to meet you and say hello. There is a diabetes educator at every clinic, please seek us out and tell us if it is your first time at RMH. We can show you around and help you with any questions or needs you might have. We’d also like to make sure you are provided with contact details for your new diabetes team
As the RMH is a busy public hospital there are occasionally waiting times for your appointment. While we always endeavour to keep waiting times to a minimum, it’s a good idea to bring a book, iPad/tablet or some homework to pass the time.
There are usually seven doctors who attend the clinic; one of these is a doctor from the Royal Children’s Hospital (RCH) who you may have seen before.
For your first clinic appointment, you will most likely see the doctor from RCH. For your subsequent appointments, you will see one of the Royal Melbourne Hospital doctors. If you have a specific preference to see a male or female doctor, please inform the doctor from the RCH of your preferred option.
For consistency, we endeavour for you to see the same doctor each visit. Occasionally your doctor may be away and you might see a different doctor.
If you require a medical certificate or certificate of attendance, please inform your doctor at the time of your appointment.
You will also have access to both a diabetes educator and a dietitian at the clinic.
Appointments are limited, so if the diabetes educator or dietitian is not able to see you on the day you attend the clinic, a specialist clinic appointment can be made. The diabetes educators also offer phone contact should you require assistance with insulin dose adjustments.
Find out more about our Diabetes Education service.
Please feel free to approach any of the team if you need assistance, information or just want to chat.
If you are on an insulin pump, we encourage you to upload your pump before your appointment. Uploading at home saves time during clinic and allows the doctors, educators and dietitians to focus on other aspects of your education and care.
If you are unable or you forget to upload before your appointment, the diabetes educator or doctor is able to do this for you in the clinic. Ask the diabetes educator to help you with this before you go in to see the doctor.
The doctor you see may provide you with requests slips for various other pathology/tests, which you will need to have done at your current appointment or before your next visit to clinic.
Blood tests can be done at Outpatient Pathology on level 1.
To test how your kidneys are functioning, you may be required to provide a urine sample (which can be done on the day of your appointment). Alternatively, you may be asked to collect your urine overnight – either for one night or for three nights in a row. Urine collection bottles are available from Outpatient Pathology on level 1. Bottles can be returned there once the test is complete.
If your doctor has given you a slip to have fundal (eye) photographs taken, this can be done immediately before your next clinic appointment. Fundal photos are taken at Medical Illustration on level 1. It is a good idea to call the phone number on the request slip to ensure you get an appointment.
Medical Illustration is equipped with a ‘non-mydriatic’ camera. This means that you will not need to have drops put in your eyes before having your photos taken. Your vision therefore won’t be affected after having eye photos taken.
During the clinic we can provide you with record books, new blood glucose meters, new pens and other equipment as required.
Various types of diabetes-related information will also be available for you to access. This includes general information on diabetes, as well as specific information on things such as pregnancy planning, sick day management, travelling with diabetes, insulin pumps, continuous glucose monitoring systems and bolus advisor blood glucose meters.
Our pre-pump information group provides an opportunity to view the various pumps offered for training at the Royal Melbourne Hospital, as well as ask questions about what is required before, when and after you begin insulin pump therapy.
The group runs once a month and the information provided will hopefully assist in your decision-making about whether a pump is right for you. If you are interested in attending this group, please advise the diabetes educator who can make a booking for you.
Find out more about using your insulin pump and the insulin pumps available for training at the RMH.
Continuous glucose monitoring
Continuous glucose monitoring (CGM) involves wearing a small glucose sensor inserted under the skin, usually in the abdomen or upper, outer buttock. The sensor measures glucose every 5 minutes and is normally worn for a 6 day period. Once complete, the data is uploaded and plotted onto graphs, enabling identification of glucose patterns.
CGM may be recommended by your doctor if you are experiencing fluctuations in your blood glucose levels, especially overnight. CGM can be offered to people using insulin pumps as well as to those on multiple daily injections. The investigation involves a day stay admission. Please speak to your doctor or diabetes educator for more information.
Find out more about our Continuous Glucose Monitoring service.
Bolus advisor blood glucose meters
Also known as bolus calculators, these blood glucose meters can recommend an appropriate insulin dose based on:
Your current blood glucose level
- The amount of carbohydrate in the food you are about to eat
- The amount of insulin still working from your previous injection
- Your target blood glucose level
- Any health events happening (such as sick days)
- Exercise you have done or plan to do
These blood glucose meters rely on accurate carbohydrate counting. Please discuss your suitability for a bolus advisor meter with your doctor, diabetes educator or dietitian.
Accurate carbohydrate counting is a requirement before starting on an insulin pump and for safe use of bolus advisor blood glucose meters. Carbohydrate counting education also offers those using multiple daily injections flexibility in their eating and enables more accurate insulin dosing for food.
Carbohydrate counting education may be completed at the Royal Melbourne Hopsital by attending a carbohydrate counting group. This group is conducted by our Endocrine dietitian. Individual carbohydrate counting appointments can also be arranged in some circumstances. Please speak to your dietitian, doctor or diabetes educator for more information.
Your doctor will determine the frequency of your appointments in clinic. The ward clerks at the appointment desk finish their working day at 5pm. If the Reception is unattended when you are ready to leave, please place your appointment request slip in the tray available. Another appointment will be sent to you in the mail.
If you have any questions, please don’t hesitate to ask either your doctor or one of the diabetes educators. We’re all very friendly and are here to help.
We acknowledge that this probably feels like a big step for you too. You are an important person in supporting your loved one to achieve their goals for their diabetes as well as reach their potential as a young adult.
Coming from a children’s service to an adult service will likely mean your role changes a little as you take more of a ‘back seat’ while your loved one gains the skills and confidence to be independent with their diabetes management (if they are not already).
Before coming to the RMH, we suggest having a chat with your loved one who has diabetes about:
- What sort of role they would like you to take now that they are attending an adult service
- Whether they are comfortable with you sitting in on their appointment
- How can you best support them while they are juggling all the changes in their life (work, study, socialising) while looking after their diabetes.
Please ask our team if you need anything and see below for some great resources specifically for you.
Are you or someone you know interested in participating in a diabetes research trial at Royal Melbourne Hospital?
Find out more about our Diabetes & endocrinology research.