Specialty Diabetes Services & Referral Pathways

The DCPNS has established a Diabetes Specialty Services and Referral Pathways Committee, under the leadership of Dr. Lynne Harrigan. This committee will review specialty services as currently provided in Diabetes Centres (DCs) throughout NSHA/IWK and recommend a model for identifying and then supporting the delivery of these specialty services, inclusive of referral pathways.  It will also propose a future role for these specialty teams in the provision of optimal diabetes care in both community and acute care settings. 

Three working groups have been established, each with a focus on a specialty diabetes population:  pediatric type 1 diabetes (T1DM); complex adult type 2 diabetes (T2DM); and pregnancy (including pregnancy in existing T1DM/T2DM and gestational diabetes.  Specific objectives of this committee and the 3 working groups include:  

• To complete an environmental scan of the services offered in the DCs across the province, with a focus on specialty populations and access to speciality physicians.
• To establish metrics in the identification and support of diabetes specialty services, in keeping with the geographic framework, community clusters, etc.
• To develop referral pathways for specific populations of patients with diabetes in need of specialty services.
• To explore and propose the future role of diabetes specialty teams in guiding/supporting diabetes care in community and acute care settings.

Current working group activities include the:

• Development of a proposal for a sessional payment model to bring specialist physicians into certain DCs to deliver team-based care.
• Development of a proposal to allow diabetes educators to directly refer patients meeting specific criteria to diabetes specialists as a Delegated Medical Function.
• Standardization of pediatric T1DM patient handouts.
• Establishment of a repository of psychosocial resources (for children/youth with diabetes) for access by diabetes teams and patients/families.
• Development of resources (checklists, learning modules) to support inpatient management of children/youth with T1DM.