Pediatric Endocrine Nutrition TEAM (PENS Team)

We work with the child with diabetes, their family and the pediatric endocrinologists to provide a comprehensive approach to diabetes management1625 Stockton Blvd, Suite 112, Sacramento, CA 95816 PENS Team phone numbers: PENS scheduling requests: 916 887 4865 PENS clinical questions: 916 887 4818PENS Fax: 916 887 4822 SPANISH LINE TO CALL PENS team : 916 887 4965


Pediatric Endocrine Nutrition TEAM (PENS Team) We work with the child with diabetes, their family and the pediatric endocrinologists to provide a comprehensive approach to diabetes management

The PENS team consists of  nurses, dietitians, and social workers who have years of experience in teaching children and their families how to care for diabetes and they work with pediatric endocrinologists from CEDE on  a consistent basis.  This is an American Association of Diabetes Educators Recognized Center and are regarded by others in the community as a premier, cutting-edge service utilizing the latest technology in managing diabetes.

Meeting with a certified diabetes educator nurse focuses on the medical part of diabetes including medications,  blood sugar patterns,  and how to manage and problem solve issues that are affecting control.  The certified diabetes educator dietitian can also help with above but their focus is on nutrition, healthy eating habits and growth.  Our licensed clinical social worker focuses on how to integrate diabetes into everyday life and is there to support the emotional side of having a chronic illness. Your doctor and/or other provider might suggest meeting with one of these experts to support you.

Types of Appointments:
  1. The comprehensive team appointment meeting all the providers – highly recommended for every child at least once a year. This is a mandatory requirement for children who have CCS (California Children’s Services), but an absolutely essential option for children with other insurances as well.
  2. Individualized appointments:  You can have an individualized appointment with one, two or all three specialists. 
  3. Group Appointments.

Types of group appointments and classes we provide:
1. Diabetes Basics Class is for those children/families that are newly diagnosed or for families that would like a refresher.  This 3 hour class allows children and families to meet others going through similar feelings and issues of the newly diagnosed while the team teaches all the skills needed to be successful in living and managing diabetes.  
2. Intro to Insulin Pump is for the children/families interested in learning more about the insulin pump. This 1 hour class describes insulin pumps and continuous glucose monitors.  We include what pumps are being prescribed by the pediatric endocrinology group, which can help you and your child, together with your doctor, pick the best pump.
3. Insulin Pump Initiation is for children getting started on their pump with insulin.  It is done in an interactive, fun group format but at the same time the children are being continuously observed to ensure insulin doses and settings on the pump is optimized.  This is a 2-day class.
4. Teen Group is for the teenager that is struggling with their diabetes and as a result blood sugar control has suffered.  The teens meet with the social worker monthly to discuss and help each other problem solve how to live with diabetes.  These groups have been very effective, allowing the teen to meet with others who are going through the same thing.  It is not a promise, but we have seen a lot of teens lower their HbA1c while attending these groups.
5. Preschool Group is a group for those children who are very young and depend completely on their parents to manage the diabetes.  It provides support for the parents in sharing resources with each other as well as tips on managing diabetes for those children who can be more sensitive to food, insulin and activity.

 In addition to what we routinely do for our children, based on our experience and assessed needs for that particular child, you as the parent/guardian can go over the list below to choose if there is an area you have identified as a specific need for your family.

o      Learn how to interpret blood sugars, look at patterns, and change insulin doses
o      Advanced pumping skills- maximizing the pump to improve blood sugars
o      Exercise and diabetes- how to manage blood sugars to improve performance
o      Computers and Downloading- creating reports to find trends in blood sugars
o      How to parent the young child, pre-teen or teenager with diabetes
o      Exploring the pros/cons of insulin pump therapy and brands available
o      Nutrition- meet with dietitian to see if current eating patterns healthy for the child and family.  Picky eaters, weight management, food battles.
o      Challenging foods and events- how to dose insulin
o      Teen issues- driving, drinking, dating
o      Transitioning from child to adult, what to know. This is a multi-session program spread over few years to optimize the transition
o      What should your child be doing independently, supervised?
o      Want to learn more about celiac disease? Gluten-free foods.
o      How to handle sick days, prevent ketones and stay out of the hospital
o      Trouble with the School Plan?  Need a 504 plan?  Get tips and advice.
o      Is your child, teen growing and developing appropriately?
o      Are you using the right meter, lancing device, pump, infusion set, and insulin pen?  Talk to a certified diabetes educator to see if you have the right equipment.
o      Social Aspects of Diabetes: Being social with diabetes, friend issues, diabetes camps, parties and special occasions.
o      Research and Diabetes: Sutter Medical Center and Center of Excellence in Diabetes and Endocrinology participate in multiple research projects. Ask us to connect you to some of the ongoing research projects.
o      Getting involved: You and your family can get involved in helping other families in the region. Ask us how and we will be glad to connect you with all the resources.

While this list is comprehensive, you might have something which is not in this list and we are willing to listen to your needs and incorporate that in your child’s care as well

Equipo de Nutrición Endocrina Pediátrica (Equipo PENS) Trabajamos con el niño con diabetes, su familia y los endocrinólogos pediátricos para proporcionar un enfoque integral para el manejo de la diabetes.

El equipo de PENS está formado por enfermeras, dietistas y trabajadores sociales que tienen años de experiencia en enseñar a los niños y sus familias cómo cuidar la diabetes y trabajan con endocrinólogos pediátricos de CEDE de manera constante. Somos un Centro Reconocido de la Asociación Americana de Diabetes y otros en la comunidad nos consideran un servicio de primer nivel y de vanguardia que utiliza la última tecnología en el manejo de la diabetes.

La reunión con una enfermera educadora en diabetes certificada se enfoca en la parte médica de la diabetes, incluidos los medicamentos, los patrones de azúcar en la sangre y cómo manejar y resolver problemas que afectan el control. El dietista certificado en educación para la diabetes también puede ayudar con lo anterior, pero se enfoca en la nutrición, hábitos alimenticios saludables y crecimiento. Nuestro trabajador social clínico con licencia se enfoca en cómo integrar la diabetes en la vida cotidiana y está ahí para apoyar el lado emocional de tener una enfermedad crónica. Su médico y / u otro proveedor pueden sugerir una reunión con uno de estos expertos para que lo apoyen.

Tipos de citas:

La cita integral del equipo se reúne con todos los proveedores: muy recomendable para cada niño al menos una vez al año. Este es un requisito obligatorio para los niños que tienen CCS (Servicios para niños de California), pero también es una opción absolutamente esencial para los niños con otros seguros.

Citas individualizadas: puede tener una cita individualizada con uno, dos o los tres especialistas.
Nombramientos grupales.

Tipos de citas grupales y clases que brindamos:

1. La Clase Básica de Diabetes es para aquellos niños / familias que han sido diagnosticados recientemente o para familias que desean un repaso. Esta clase de 3 horas permite que los niños y las familias conozcan a otros que están pasando por sentimientos y problemas similares al recién diagnosticado, mientras que el equipo enseña todas las habilidades necesarias para tener éxito en la vida y el control de la diabetes.

2. La introducción a Insulin Pump es para los niños / familias interesados ​​en aprender más sobre la bomba de insulina. Esta clase de 1 hora describe bombas de insulina y monitores continuos de glucosa. Incluimos qué bombas prescribe el grupo de endocrinología pediátrica, que pueden ayudarlo a usted y a su hijo, junto con su médico, a elegir la mejor bomba.

3. La iniciación de la bomba de insulina es para niños que comienzan a usar su bomba con insulina. Se realiza en un formato grupal interactivo y divertido, pero al mismo tiempo se observa a los niños continuamente para asegurar que las dosis de insulina y los ajustes en la bomba estén optimizados. Esta es una clase de 2 días.

4. Teen Group es para el adolescente que está luchando con su diabetes y como resultado el control del azúcar en la sangre ha sufrido. Los adolescentes se reúnen mensualmente con el trabajador social para discutir y ayudarse mutuamente a resolver el problema de cómo vivir con diabetes. Estos grupos han sido muy efectivos, permitiendo que el adolescente se reúna con otros que están pasando por lo mismo. No es una promesa, pero hemos visto a muchos adolescentes reducir su HbA1c mientras asistían a estos grupos.

5. Preschool Group es un grupo para aquellos niños que son muy pequeños y dependen completamente de sus padres para controlar la diabetes. Brinda apoyo a los padres para compartir recursos entre sí, así como consejos sobre cómo controlar la diabetes para aquellos niños que pueden ser más sensibles a los alimentos, la insulina y la actividad.

 Además de lo que hacemos rutinariamente para nuestros hijos, según nuestra experiencia y las necesidades evaluadas para ese niño en particular, usted como padre / tutor puede revisar la lista a continuación para elegir si hay un área que ha identificado como una necesidad específica para Tu familia.

o Aprenda a interpretar los niveles de azúcar en la sangre, observar patrones y cambiar las dosis de insulina.

o Habilidades avanzadas de bombeo: maximizar la bomba para mejorar el azúcar en la sangre

o Ejercicio y diabetes: cómo controlar el azúcar en la sangre para mejorar el rendimiento

o Computadoras y descargas: creación de informes para encontrar tendencias en los niveles de azúcar en la sangre.

o Cómo criar al niño pequeño, preadolescente o adolescente con diabetes

o Explorar las ventajas y desventajas de la terapia con bomba de insulina y las marcas disponibles.

o Nutrición: reúnase con un dietista para ver si los patrones de alimentación actuales son saludables para el niño y la familia. Comedores quisquillosos, control de peso, batallas de comida.

o Alimentos y eventos desafiantes: cómo dosificar insulina

o Problemas de los adolescentes: conducir, beber, salir

o Transición de niño a adulto, qué saber. Este es un programa de varias sesiones que se extiende durante algunos años para optimizar la transición.

o ¿Qué debe hacer su hijo de forma independiente, supervisado?

o ¿Quieres aprender más sobre la enfermedad celíaca? Alimentos sin gluten.

o Cómo manejar los días de enfermedad, prevenir las cetonas y permanecer fuera del hospital.

o ¿Problemas con el plan escolar? ¿Necesita un plan 504? Obtenga consejos y sugerencias.

¿Su hijo, adolescente está creciendo y desarrollándose adecuadamente?

o ¿Está utilizando el medidor, el dispositivo de punción, la bomba, el equipo de infusión y la pluma de insulina correctos? Hable con un educador certificado en diabetes para ver si tiene el equipo adecuado.

o Aspectos sociales de la diabetes: ser social con diabetes, problemas de amigos, campamentos de diabetes, fiestas y ocasiones especiales.

o Investigación y diabetes: el Centro Médico Sutter y el Centro de Excelencia en Diabetes y Endocrinología participan en múltiples proyectos de investigación. Pídanos que lo conectemos con algunos de los proyectos de investigación en curso.

o Involucrarse: usted y su familia pueden involucrarse en ayudar a otras familias en la región. Pregúntenos cómo y estaremos encantados de conectarlo con todos los recursos.

Si bien esta lista es completa, es posible que tenga algo que no está en esta lista y estamos dispuestos a escuchar sus necesidades e incorporarlas también en el cuidado de su hijo

1625 Stockton Blvd, Suite 112, Sacramento, CA 96816
Phone:  916. (916)262-9165 and (916) 262 9114

Rosanna Hannum, CNS, CDE Rosanna Hannum has been a registered nurse for 20 years.  She is also a clinical nurse specialist receiving her master’s in nursing in 2005, specializing in pediatric endocrinology.  She worked in the hospital as a pediatric nurse from 1994-1999 and enjoyed teaching children and their families who were newly diagnosed with diabetes.  She then moved to the PENS clinic, where she has taught children with diabetes for 16 years.  She is a certified diabetes educator and a pump trainer.  She loves her job and hopes to make diabetes easier to manage for all her patients and their families.  She also has had type 1 diabetes for 30 years.

Lisa Metzger, RN, CDE Lisa Metzger completed her Bachelor of Science degree from California State University, Sacramento in 1986.  Lisa is a Certified Diabetes Educator and Certified Pump Trainer.  She has more than 25 years of nursing experience, including work in the NICU as a bedside nurse and as a discharge planner.  For the past 14 years she has been one of the nurses on the PENS team where she is dedicated to helping patients and families understand that they can live well with diabetes.  Her job allows her to combine a lifelong desire to teach with a passion for nursing.  

Marisa Salas-Silva,  LCSW Marisa Salas-Silva is a Licensed Clinical Social Worker. She received her master’s degree in Social Work in 2007 from San Diego State University. As part of her training Marisa has worked with children, adolescents, and adults in both medical and school settings. She has been with Sutter Health since 2012 and worked as a per diem employee in both the hospital and outpatient clinics where she covered the Pediatric Endocrinology and Nutrition Services. In 2013 she took the opportunity to become a part-time and eventually a full-time social worker at the clinic. Marisa provides support to patients and their families living with chronic medical conditions and is enthusiastic about working with a team who is committed to their patients.

Shaun Gray, LCSW Shaun Gray has been a social worker at Sutter for 19 years.  She started her career working in the post partum and NICU units at Sutter Memorial.  She has worked in the outpatient clinics since 2003 in the pulmonary team, GI team and craniofacial clinic.  She began working on the PENS team March 2013 on Fridays.  Shaun enjoys working with teen patients and their families.  Her areas of expertise are adherence with medical treatment and parenting children with health issues.

Geneva Foncannon, RD, CDE Geneva received her Bachelor’s degree in Dietetics from UC Davis, then went on to complete her Dietetic Internship at the Brigham and Women’s hospital in Boston, Massachusetts.  By far, her favorite rotation was at the Boston Children’s Hospital, which launched her efforts at pursuing a career in pediatric nutrition.  She joined Sutter Children’s Center, working on the PENS team in 2001 and hasn’t looked back since!  She became a Certified Diabetes Educator later that year and has maintained this as her specialty in pediatric nutrition, allowing her to combine this expertise with the medical management of diabetes.   She is passionate about helping families improve the feeding relationship, especially within the constraints of managing diabetes, which naturally requires a significant amount of focus on food.  She has enjoyed how her career has morphed over the years, and most recently is excited by coordinating the PENS team insulin pump program with the help of her colleagues.  Geneva identifies that supporting children and their families to live healthy, happy lives with diabetes brings her the most joy!

Erin Love RD Erin received her second bachelor’s degree in Dietetics from CSU Sacramento, then went on to complete her Dietetic Internship also at CSUS.  She joined the Sutter team in 2011 initially working inpatient, primarily working with high risk maternity and adult patients but also covering in pediatrics, outpatient Sweet Success and inpatient diabetes education.  She made the move over to outpatient in 2016 and is loving the new role!  She works in PENS Clinic, Mothers of Multiples and Sweet Success, which provides services to pregnant women who have type 1, type 2 and gestational diabetes.  She loves all aspects of food:  cooking, baking, cake decorating, recipe development and of course eating.  She also has an interest in plant based eating.  Her favorite parts of her new role are talking about food and working with patients and families to help them reach their goals.

Janeka Whitelaw, OPAR

Janeka Whitelaw is the Outpatient Admissions Support Representative for the Sutter Children’s PENS team. She is currently attending college at American River College working on her AA in Sign Language studies. She has 2 year old son who gives me lots of unwanted exercise every day. I have worked for Sutter in Pediatrics for 10 years and being around children is what I love most. My job is to schedule all new patient referrals and to stay up to date on any authorizations needed for our patients to be seen by the PENS team.  The most important part of  my job is making sure our families get the best experience within our department. We definitely work as a team here and treat our families as if they were our own

Pediatric Diabetes  CONFERENCE 2018 
Click on the links below to download presentations: 
Celina Trujillo Type 2 Diabetes

Faced Paced Evolution of Diabetes Technology
Happiness - Dr. Prakasam
Real Life Diabetes Case Studies
Gut Microbiome

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