Spring 2014 - Atlantic Health System

BD DIABETES CENTER
FOR
CHILDREN
AND ADOLESCENTS
Goryeb Children’s Hospital
Morristown Medical Center
100 Madison Ave.
Morristown, NJ 07960
Phone: (973) 971-4340
Fax: (973) 290-7367
The Team
Physicians:
Harold Starkman, MD, Director
Barbara Cerame, MD
Sunita Cheruvu, MD
Daisy Chin, MD
Marianna Nicoletta, MD
Lawrence Silverman, MD
Nurses:
Frances Melchionne, EdD, RN, CDE
Clinical Coordinator
Sascha Dougan, RN, BSN
Laurie Ebner-Lyon, RN, APN, CDE
Kristin Sabanosh, RN, APN, CDE
Christine Wagner, RN, MS, CDE
Nutritionist:
Connie Shirtz, RD, MS, CDE
Social Worker:
Nicole L Pilek, MSW, LCSW
Administrative Staff:
Donna Parente, Office Manager
Debby Ace, Endocrine Coordinator
Cheryl Baldwin
Ashaki Graham
Sheryl Irons
Joann Millman
Christie Murillo
Medical Assistants:
Pamela Solomon
Pierre the Pancreas
The Glucose Monitor
SPRING 2014
FROM THE DIRECTOR’S CHAIR
After a long, cold and snowy
winter, it seems as if spring has
finally arrived. The days are longer
and the piles of snow appear to be
slowly shrinking. The arrival of
spring also signals the time of year
when new diabetes research is
presented at the American Diabetes
Association Scientific Meeting
which takes place during the second
week of June, this year in San
Francisco.
It was during the spring and
summer of 1921 that insulin was
first injected into a dog with
diabetes, lowering the dog’s blood
sugar into the normal range. By the
end of 1921, with the help of
Canadian chemist James B. Collip
and Scottish physiologist J.J.R.
Macleod, Banting and Best purified
insulin for human use. In January of
1922, for the first time in history,
insulin was successfully
administered to Leonard Thompson,
a 65 pound, 14 year old with severe
diabetes, changing type 1 diabetes
from a fatal disease with an average
life expectancy of 2.4 years, to a
disorder which could be effectively
treated with medication.
In 1922, when Lilly began
distributing Isletin, a relatively
impure, short acting insulin, type 1
diabetes management was
characterized by painful injections,
multiple times daily with reusable
glass syringes requiring sterilization
after each use. In addition,
monitoring was limited to boiling
urine and testing it four times daily
for sugar, an unpleasant and
inaccurate chore. Due to the lack of
quick and easy fingerstick blood
sugar measurements, severe high
and low blood sugars were not
uncommon. Even at medical
laboratories, blood glucose testing
required a large blood sample and
hours of lab analysis.
Harold Starkman, M.D.
Although the availability of
insulin allowed people with type 1
diabetes to survive longer,
normalizing their blood sugars was
not possible. In addition, the role of
high blood sugars as a cause of
diabetes complications was
controversial until relatively
recently. This knowledge and
technical gap resulted in a high
incidence of severe diabetes
complications, which remained
unchanged from the 1930’s until the
1970’s.
During the 1970’s and 1980’s,
the introduction of finger stick
blood sugar testing, utilization of
hemoglobin A1C as a marker of
blood sugar control and Diabetes
Control and Complication Trial,
which confirmed the relationship
between high blood sugars and
diabetes complications, improved
diabetes management, resulting
again in improved prognosis.
Subsequent advances in diabetes
management including the
development of genetically
engineered insulins starting with
Humulin in 1982, commercial
release of insulin pumps in 1981
and FDA approval of continuous
glucose monitors in 1999 continued
this trend.
With newer research projects
targeting closed loop insulin
delivery systems (artificial
pancreas), more effective islet cell
transplantation and even the
development of new medications to
prevent type 1 diabetes, it is likely
that diabetes management will
continue to improve. Monitoring
news releases during this year’s
ADA meeting in mid-June, as well
as checking out the American
Diabetes Association, Juvenile
Diabetes Research Foundation and
Diabetes Research Institute websites
can also provide a reassuring
overview of what’s happening in
type 1 diabetes research.
Although the pace of research
often feels slow to those forced to
live with diabetes, a look backward,
into even the recent past, shows a
pattern of continuing advances, and
one can be optimistic that these
improvements in diabetes care will
continue in the future. In the
meantime, as Dr. Elliott Joslin, the
father of modern diabetes care, first
wrote over 75 years ago, “Diabetics,
take this lesson to heart! Keep your
urine sugar free, your blood sugar
normal and your diabetes
controlled….and thereby keep alive
to profit by some new discovery!”
For further information on the
fascinating history of type 1
diabetes and its management:
*The Discovery of Insulin by
Michael Bliss University of Chicago
2007 ( if you prefer seeing the
movie version you can find “Glory
Enough for All” 1988 on Amazon)
*Breakthrough: Elizabeth Hughes,
the Discovery of Insulin, and the
Making of a Medical Miracle Thea
Cooper and Arthur Ainsberg, St
Martin’s Press, 2010
*Bittersweet: Diabetes, Insulin, and
the Transformation of Illness, Chris
Feudtner, John Christopher
Feudtner, University of North
Carolina Press, 2003
PAGE
2
#THROWBACK“THURSDAY”
“First Insulin Pump -1963”
Come expand your knowledge at an advanced pumping class!
“Making Your Pump Work Smarter Not Harder”
The BD Diabetes Center is offering an education program to help you get more from your insulin pump. Come join other
pumpers and together discover the tools and information you need to take insulin pump therapy to the next level.
Class Dates:
 Thursday, May 15, 2014
 Thursday, June 26, 2014
 Thursday, September 25, 2014
Goryeb Children’s Hospital, 2nd Floor. Community Conference Room
7:00 to 9:00 P.M.
To Register call Fran Melchionne @ 973-971-4340
Or [email protected]
THE
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MONITOR
SPRING
2014
PAGE
WHEN IN ROME…
As a former high school student and college
student with type 1 diabetes, there are two
statements that are important to keep in mind
when making the transition from high school
to college. The first - having diabetes will
only hold you back if you let it. The second –
nobody is responsible for you (and your
health) but yourself.
While managing your diabetes comes first
and foremost, please take my advice – never
let it get in the way of doing anything you
want to experience during college whether it
is academic, professional, or social.
Even as a person with type 1 diabetes, I
took advantage of one of these opportunities
and was fortunate enough to spend a
semester studying abroad in Rome, Italy
during my junior year at the University of
Massachusetts. I highly suggest taking
advantage of this type of experience if you
are at all interested. I would like to share
some quick tips from my personal
experiences in case you have any doubts
that diabetes is preventing you from doing
something similar.
Having diabetes was not something I was
going to let stop me from taking advantage of
this life changing opportunity no matter what
difficulties arose. To be honest, between all
the traveling, foreign languages, and different
cultures I had hardly any issues while
abroad. Most people who I came into
contact with were familiar with diabetes and
knew about insulin pumps. Through all the
planes, trains, and automobiles I only was
questioned about what my insulin pump was
once and made sure to keep my medical
bracelet on at all times.
It can be a bit frightening to be surrounded
by foreign languages and in the event an
issue or emergency might arise, I thought it
was useful to know how to say “diabetes” in
whatever language was spoken in the
country I was visiting. Another important
point is to make sure when traveling that you
always have a supply of insulin with you in a
carry-on bag, because if a checked bag
becomes lost you will be unable to get what
you need shipped. Shipping supplies across
borders is possible, but takes a long time to
go through customs and insulin often cannot
be shipped overseas. If you are without it or
become separated from it, there would be no
way to get more. I brought a full four month
supply of everything I needed (including
insulin) with me as a carry on item and had
no issues by doing that.
Another helpful tip to keep in mind is that
(If you would like
to contact Dan,
please e-mail
Nicole, the social
worker and she will
be happy to pass
along his e-mail.)
THE
GLUCOSE
MONITOR
3
BY DAN CURRY
in different countries stores often close or do
not open certain times or days of the week
you might be used to here at home. It is
important to always have glucose tabs and
juice to treat lows at all times so that you do
not run out without a way to pick something
up. Your daily routine and food intake will
also change dramatically and it is crucial to
keep in mind what type of new foods you’re
eating and how active you’ll be. It is very
likely you will walk A LOT, like I did when
exploring new cultures and cities, which led
to many lows when I first arrived.
As I said, I had no other major issues
during my time in Rome and other European
cities. I attribute that to being over prepared
for every situation. The “culture shock”
phase when you first arrive is the hardest
and most important time to monitor yourself
even more so than you otherwise would but
after you adjust, studying abroad will be no
different than living at school.
I hope that your transition from high school
to college is a great one and I wish you the
best of luck. By staying healthy, being
responsible, and taking advantage of
opportunities I hope you will feel as fortunate
as I have felt to grow into an adult and have
a great time
along the way.
PAGE
4
SWEET TALK
with team member
Connie started working at
Morristown Medical Center
26 years ago as the outpatient
Dietitian.
She worked as the nutritionist
for the Adult Diabetes Center
for eight years before switching
to pediatrics nine years ago.
She is a Certified Diabetes
Educator, and has her Master’s
Degree in Human Nutrition.
Connie enjoys spending
time with her children, Jeff and
Jamie. She can often be found
sitting in the bleachers or stands
cheering them on during their
sporting events, which include
CONNIE SHIRTZ
baseball and volleyball. Jeff is
a freshman in college, and
Jamie is in her junior year of
high school.
Anyone that knows
Connie, can tell you which
professional team she is a
die-hard fan of...any guesses?
The NEW YORK METS!!
Connie also loves the
beach and the warm weather.
She vacations every summer
with her family down the
Jersey shore. You will find
her on the beach, soaking up
the rays and reading; catching
up on all her magazine
subscriptions and books on her
“must-read” list. She also plays
a mean game of mini-golf.
Connie has an altruistic
side to her. Whether it be
assisting others in need, or
helping to organize events to
raise money for a good cause,
Connie is always willing to
lend a helping hand!!
Connie’s perfect day is
relaxing at home with friends
and family with a good home
cooked meal, and a fire in the
fireplace.
She truly loves working with
our patients and their families.
Connie’s pride and joy...Jeff and Jamie
The Shirtz Kids wearing sweatshirtz!
THE
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MONITOR
SPRING
2014
PAGE
Celiac Disease & Type I Diabetes
BY: DR. MARIA PEREZ
Pediatric Gastroenterologist @ the Goryeb Children’s Hospital, Morristown, NJ
Celiac disease is a chronic condition that affects the small intestine. It is a permanent
sensitivity to gluten (a protein found in wheat, rye and barley). In patients with celiac disease,
eating foods that contain gluten leads to damage to the villi (finger-like projections) in the small
intestine. Celiac disease, just like type I diabetes, is considered an autoimmune disease –
meaning it causes a person’s immune system to attack itself.
Patients with celiac disease can have a variety of symptoms including abdominal pain,
bloating, constipation, diarrhea, poor growth, and delay in puberty. They can have anemia, an
increased risk of fractures, rashes, and abnormal liver tests. Patients with celiac disease can also
have no symptoms at all.
It is estimated that 1 in every 100 people in the United States have celiac disease. Certain
children are at higher risk for celiac disease including those that have type I diabetes,
autoimmune thyroid disease, dermatitis herpetiformis, Down syndrome, Turner syndrome,
Williams syndrome, or have a relative with celiac disease. According to the guidelines from the
North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition
(NASPGHAN), it is recommended that children in these high-risk groups (even without
symptoms) should be tested for celiac disease after 3 years of age after the child has been on an
adequate gluten-containing diet for at least 1 year before testing. The initial test of choice is the
tissue transglutaminase (TTG) antibody. If this TTG is negative, it is unlikely that the child has
celiac disease at this time. However, children in these high-risk groups should be tested at
regular intervals (usually yearly). If this TTG is positive, children should be referred to a
pediatric gastroenterologist for further testing – including an endoscopy with biopsy to confirm
the diagnosis of celiac disease. (A flexible tube-like instrument is placed through the mouth,
down the throat, past the stomach and into the small intestine to obtain small tissue samples).
Treatment of celiac disease consists of lifetime avoidance of gluten-containing foods.
Initially it can be difficult to change to a gluten-free diet. This can be even more difficult when
you are given the “double diagnosis” of type I diabetes and celiac disease. Dietitians and
support groups can help children and families adjust to this lifestyle change. There are some
reports that suggest that patients with type I diabetes and celiac disease have fewer episodes of
hypoglycemia (low blood sugar), better overall blood glucose control, and improved weight gain
and growth if they strictly follow a gluten-free diet.
Additional Resources:
www.celiachealth.org
www.CDHNF.org
www.NASPGHAN.org
www.gikids.org
5
SPRING
2014
PAGE
6
The BD Pediatric Diabetes Center will be presenting a program for
school nurses on October 13, 2014. It is titled:
“Insulin Pump Therapy in Pediatrics” and will run from 9:00am –
4:00pm. The objective is to increase the understanding of insulin
pump therapy in the pediatric population for school personnel and
provide a “hands on” workshop for insulin pumps. Topics to be
discussed include a history of the insulin pump, infusion sets, insulin
on board, advanced pump features, carbohydrate counting , indications for pumps in
pediatrics and small group demonstrations of a select number of insulin pumps. If there
are any questions please call Fran Melchionne at 973-971-4024. Please feel free to pass this
information along to your school nurse.
The SOCIAL(Net)WORK(er)
notes from Nicole
We are never too young and it is never too late to begin thinking outside ourselves and considering others. Empathy,
compassion and altruism are significant to human survival and help enable the human race to not just exist, but
actually flourish. So much good comes out of “paying it forward”. I am so impressed and deeply moved by the selfless
acts I have witnessed here at this center. It is awesome when a patient decides, that instead of birthday gifts, he
wishes for his friends and family to buy stuffed animals so they can be donated to children in the hospital newly
diagnosed with type 1 diabetes. It is incredible when a patient that notices the pediatric floor is missing a really good
movie that he thinks other hospitalized children will enjoy and uses his own gift card to purchase it for them. Not to
forget all the community service projects that helped other patients in need, the walks taken to raise money for worthy
causes and the countless hours donated to making sure programs and events are a huge success.
There are so many ways and opportunities to donate your time, talent or treasure. You could volunteer in your
community, you could get involved here at the center or hospital, and you can even make a difference while you shop!
Here are some ideas to get you thinking about giving back:
*The website for information about becoming a junior volunteer at the hospital...
http://www.atlantichealth.org/morristown/ways+to+give/volunteering/volunteering+at+morristown+medical+center
*There is also a Kids4Kids committee through the Foundations Department of the hospital…
http://www.f4mmc.org/Ways-to-Give/Donate-Your-Time/Community-Based-Events/Kids-4-Kids.aspx
*If you shop online and like to order from Amazon.com you can go to the website Smile.amazon.com. It is the same
products, same prices, and same service; Amazon just donates 0.5% of the price of your eligible AmazonSmile
purchases to the charitable organization of your choice. You can select charities such as JDRF (Juvenile Diabetes
Research Foundation) and FDR (Foundation for Diabetes Research) and ADA (American Diabetes Association).
Send me an e-mail ([email protected]) or give me a call (973.971.6465) if you are interested in
volunteering here at the center and keep an eye for e-mails that offer opportunities to get involved!
THE
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“Providing service
and extending
charity towards
others helps us
overcome our own
difficulties and
makes them seem
less challenging." Silvia H. Allred
SPRING
2014
PAGE
7
MAKING THE TRANSITION TO COLLEGE AND TAKING DIABETES ALONG:
WORDS OF WISDOM FROM A COLLEGE STUDENT
BY: HAYLEY L.
As senior year comes to a close and the
summer approaches, students eagerly look
forward to beginning college, a new and
mysterious chapter in their lives. It is an
exciting time filled with unfamiliar
chances, such as meeting a different group
of friends and designing a schedule on
your own! Although it may seem daunting
initially, the entire process is extremely
rewarding, as there are a multitude of new
opportunities just waiting to be explored.
I was diagnosed with diabetes
during November of my senior year of
high school while I was in the midst of
college applications. The news flipped my
world upside down and made me
reconsider all my options. I was
overwhelmed by everything happening at
once, as it was hard to imagine myself
handling the rigors of the disease on my
own. Thankfully, I was able to master it
quickly and acclimate to my new life. In
order to avoid difficulties, it is important
to find different ways to incorporate
diabetes into a daily routine that
establishes comfort and familiarity with
the condition.
The college application is a long
and nerve-racking process for any student,
and is only made more difficult by the
added stress of having diabetes. Although
we often want to forget that we have the
disease, it is important to consider your
health throughout the college search. For
some, living at home is the best option, as
it can save money and will not disrupt
his/her organized routine. Others may
desire to live away at school, possibly in
the hopes of becoming more independent
or needing a change of scenery.
Personally, I decided to live at home for
many reasons, including the prestige of
the program that I chose to study, but I
would be lying if I said that my diabetes
was not a factor in that choice.
The first few weeks of college
may seem intimidating, as you must
acclimate to a large campus with groups
of new faces. This can be overwhelming,
but in no time, the school will begin to
feel like home. Since every freshman are
new to the college environment, there so
many chances to make friends. You will
be surprised by how friendly everyone is,
including people who live on your dorm
THE
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MONITOR
floor, peers in your classes, and students
who frequent the library or gym. The most
important part of meeting new people is to
be friendly and keep an open mind. A
person may seem "different" from anyone
you have ever been friends with, but he/
she may turn out to be your best friend.
You will make friends with some of the
most exciting, interesting people, who will
expose you to new opportunities.
In college, there is a great deal of
freedom due to flexible schedules, which
grants students with the ability to make
many- if not all- of their own choices.
This is a liberating yet terrifying feelingwe are still so young when we enter
college, but we are given the ability to act
as adults. In order to stay on track while
forging for independence, it's important to
create a routine that you will maintain. If
you ignore your school work so that you
can go out with friends every night, your
grades will drop. On the contrary, if you
let your work become so overwhelming
that you never let yourself have fun, you
will suffer from a dwindling social life.
College is a balancing act of choices and
consequences; be smart in managing your
time and your life will be way less
stressful.
In the first few weeks of college,
it is important to establish a reasonable
routine for yourself in order to maximize
your time. At the start of each semester, I
plan out what times I will be in the library
between classes in order to study and I use
a notepad to record the dates of all my
upcoming assignments and tests. This
keeps me organized, especially when there
are multiple long-term projects to work
on. Also, it is important to leave room for
other events, such as time to meet up with
friends, go to the gym, or enjoy a relaxing
day off. In order to avoid lows during
class, I plan out my meal times so that my
blood sugar stays stable throughout my
time at school. It is hard adjusting to a
new schedule where my meals aren't at the
same time every day, so it takes a few
days to figure out the best routine.
Diabetes presents its own set of
challenges in the college experience.
Initially, I was apprehensive to tell my
friends about my condition but I did not
want to be known as "the diabetic girl," a
title I had hoped to abandon after high
school. I kept it hidden for a few months,
but eventually told a few people, who
were extremely normal about it. It is up to
you if you want to tell others, but I have
had only positive experiences when telling
others. In fact, by opening up, I have met
many others with diabetes and talked to
students who have been affected by the
condition. It is always comforting to know
others who have the same condition, as it
offers the opportunity to share similar
experiences or provide help to another
person with diabetes who is in need.
Additionally, it is important to
manage stress levels because added
pressure is often dangerous to blood
sugar. In my experience, this Spring 2014
semester has been the hardest due to a
challenging course load of six classes; it
can be difficult to balance classes, work,
and diabetes. Unfortunately, the stress can
raise your blood sugar, which adds more
chaos to an already rough time. During
these times, I try to find ways to manage it
all without losing track of what I need to
get done. I found that a simple 15 minute
yoga session or a nice long talk with a
friend can help alleviate the stress and
reduce my elevated blood sugars. College
has shown me that you can't sweat the
small because not every day will be
perfect, but you have to find a way to
make it all enjoyable.
As the old saying goes, college
truly is the best four years of your life.
Enjoy every day of it, because it goes by
extremely fast. It is a very busy time, so it
is important to stay focused, because it
can be easy to let stress become
overwhelming. Although having diabetes
can be quite the nuisance during these
years, it can be managed with little stress.
My best advice is to take good care of
yourself because your health is the most
important value that you have. Some days
may seem chaotic, while others are
blissfully relaxing; take each day in stride
and enjoy the fun of these four years!
CARB COUNTING WITH CONNIE, the dietitian
PAGE
8
LUMIERE’S
Luscious Lemon Bars
Ingredients:
FOR THE SHORTBREAD:
FOR THE FILLING:
¾ cup butter, at room temperature
2 Lemons
1 ½ cups all-purpose flour
4 eggs
½ cup confectioners’ sugar
Lumiere’s Tip:
If you are having
guests, this sweet
treat is just the thing
to serve. Pint-size
chefs can use their
hands to work the
dough, and then they
can zest the lemons.
1 ½ cups sugar
¼ cup all-purpose flour
Instructions:

Heat the oven to 350 F. For the shortbread crust, use your fingertips to work the butter, flour, and
confectioners’ sugar in a large bowl until the mixture holds together. Transfer the dough to an
ungreased 9 X 13-inch pan and press it into the pan. Bake for 20 minutes, or until the edges begin
to brown.

While the shortbread is baking, make the lemon filling. Wash and dry the lemons, then grate the
rinds using the small holes on your grater (you will need 2 tablespoons of zest). Slice each lemon
in half and squeeze the juice into a measuring cup until you have ½ cup. Remove any seeds.

In a large mixing bowl, whisk together the eggs and sugar. Whisk in the flour. Stir in the lemon
zest and juice. When the shortbread has baked, pour the filling over it and return the pan to the
oven for another 20 to 25 minutes or until the filling no longer jiggles and the edges are lightly
browned. (Test by inserting a knife in the middle.) Cool and dust with confectioners’ sugar.
Refrigerate any leftovers.
Serving: 1, 2-inch square; Calories: 157; Total Fat: 7 grams; Total Carbohydrate: 22 grams; Fiber: 1
gram; Protein: 2 grams
ALICE’S
Chicken Salad Tea Sandwiches
Ingredients:
Alice’s Tip:
1 ½ pounds raw boneless, skinless chicken breasts
1 small onion, quartered
1 ½ teaspoons tarragon
½ to ¾ cup mayonnaise
20 green grapes
Salt and pepper, to taste
1/3 cup slivered almonds (optional)
16 slices of bread of choice
Instructions:

No tea party---or unbirthday party--- is complete without
these sandwiches!
For safety’s sake, ask
kids to use a plastic
knife instead of a
sharp one to cut the
grapes.
THE
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MONITOR
To make the salad, cut the chicken into 2-inch cubes and place in a saucepan. (Thoroughly wash
your hands and cutting board afterward.)
 Add water to cover, mix in the onion and 1 teaspoon of the tarragon, and cook over high heat.
 Once the water boils, reduce the heat and simmer for 20 minutes. For best results, check the
chicken for doneness: the center should be white with no traces of pink.
 Drain the water from the saucepan and transfer the chicken to a cutting board. Remove the onion,
but don’t remove the tarragon.
 Cut the chicken into small pieces and place it in a large bowl.
 Add the mayonnaise and toss well.
 Slice the grapes and add them to the bowl, stir in salt, pepper, and additional tarragon to taste.
Stir in the almonds, if desired. Cover the salad and refrigerate.
 To assemble a tea sandwich, remove the crusts from 2 slices of bread, add the chicken salad filling, and cut the resulting sandwich into squares or triangles. Makes about 3 cups chicken salad,
enough for 8 full-size sandwiches.
Serving: 1 full-size sandwich, or 4 tea sandwiches; Calories: 429; Total Fat: 18 grams
Total Carbohydrate: 40 grams (depending on the bread selected); Fiber: 3 grams; Protein: 26 grams
******Chicken salad alone contains 4 grams total carbohydrate per 1/3 cups serving
recipes courtesy of
Dishing it Up Disney Style: A Cookbook for Families with Type 1 Diabetes
PAGE
9
Trying to Understand the World of Insurance...
Medical insurance seems to be the topic of conversation with many Americans lately.
It can be very challenging to try to understand your policy and what it provides.
Our office is communicating with insurance companies every day to attempt to get
the services and supplies that are needed for our patients.
Be aware that insurance companies many times place limits on the number of test
strips and lancets they are willing to pay for each day. When this happens we must
submit for a prior authorization to override the limit of supplies your policy provides. Prior authorizations require paperwork to be completed and sent back to the
insurance company. They will review the request and communicate to us if the
request is approved or denied. This process takes time to occur.
Sometimes insurance companies place “exclusions” on items. This means they have
decided they will not pay for certain supplies or services and no prior authorization is
allowed.
Another issue we would like to bring to your attention is that your medical
insurance or pharmacy coverage determines their formulary brand of medications
and supplies. When prescribing medications our physicians will use the formulary
medications chosen by your insurance company or pharmacy benefit manager in
order to pass along the lowest copay for you. This will be the case for meters and
insulin. We will need to order the “preferred” brands.
Employers make changes to insurance policies frequently. An item that you
received the last time you filled your prescriptions may no longer be available the
next time you reorder. Employers should provide you with a list of approved
medications and supplies. It is up to you to keep current with your policy.
Also, in the event you change insurance plans or pharmacy benefit managers your
formulary of medications and supplies may change and we may need to order a different brand of supplies for you. Please notify our office if your insurance plan has
changed. This will facilitate our ordering the correct prescriptions from the correct
pharmacy or mail order. We do not participate in all insurance plans. If you plan to
change insurance you may want to call our office and confirm that our services will
be in network.
Please know we are always here to try to get the equipment you need so you can
maintain the highest level of care possible. Sometimes all of our best efforts cannot
overturn the decision of an insurance company.
THE
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MONITOR
SPRING
2014
PAGE
10
WARNING!!...PLAN AHEAD!!...
THE EMR IS COMING!!...THE EMR IS COMING!!..
(ELECTRONIC MEDICAL RECORD)
STOP! READ! STOP! READ!
Be sure to schedule your appointments
with the doctors and nurses early. Try
to make your appointment when you
leave from your present appointment.
The Goryeb Children’s Hospital is going
to be converting to an electronic
medical record in July. There will be
no more paper charts. The doctors,
nurses and ancillary staff will have
extensive training that will be taking
place, making available appointment
times limited for the summer. We plan
to be back to our regular scheduling
practices in the fall.
THE
GLUCOSE
MONITOR
SPRING
2014
PAGE
11
The maginative Site:
The section to inject your creativity!!
Wanna share your artistic talent with others? Submit your paintings, drawings, photography or poems!!
Amazing and super talented artist, Christy, shares
her love of Anime character drawings...
Oh WOW!!!
THE
GLUCOSE
MONITOR
BD Diabetes Center for Children and
Adolescents
Goryeb Children’s Hospital at
Morristown Medical Center
100 Madison Ave
Morristown, NJ 07962
Office Phone #: 973.971.4340
Fax #: 973.290.7367
THE
GLUCOSE
MONITOR
Easier Prescription Refills!
There is a fast, and easy way to get your prescriptions
refilled and it’s free!! Our office participates in
Relay Health, a web-based secure service for
requesting prescription refills. We strongly
encourage patients to use Relay Health for efficient
and timely renewals. Simply register online at
www.relayhealth.com or provide your e-mail address
when you register for your next appointment.
Remember – After hours and weekends,
on-call physicians do not have access to your
child’s chart and cannot authorize
prescription refills.
A Pharmacist can dispense 3 days of diabetes related
supplies without a prescription; this may be an
out-of-pocket expense. It’s always best to request
your prescriptions at your scheduled diabetes
appointments, or by using Relay Health.

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