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Centre for Complex Diabetes Care

North York General Hospital is one of six centres across Ontario to have received funding from the Ontario Diabetes Strategy to host a Centre for Complex Diabetes Care (CCDC). The North York General CCDC is a regional program, servicing all of the Central Local Health Integration Network (LHIN).

Model of care
While most patients usually manage quite well with standard levels of care, the CCDC provides comprehensive care for patients with complex diabetes needs. Care is provided over a shorter term, is patient-centered, goal specific, and allows for frequent follow-up.

The CCDC assists with coordinating care among health care providers to maintain a patient's continuity of care and to avoid duplication of service.

Criteria
Patients seen in the CCDC include adults 18 years of age and older who are experiencing one or more of the following:
  • Unmanaged diabetes complications
  • Comorbidities which impact glycemic control
  • Barriers in accessing health care: e.g., serious mental illness/poor mobility/frail elderly
  • Recurrent hospitalization/emergency room visits
  • Complexities requiring case management
Patients may be managed on either oral medications, insulin, or both.

To enhance access for patients to the CCDC across the Central LHIN, innovative health care delivery systems such as Ontario Telehealth Network will be used.

The team:
The team consists of the following experienced registered professionals:
  • Endocrinologists
  • Nurse practitioners
  • Nurses
  • Dietitians
  • Social workers
  • Chiropodist
  • Pharmacist

The CCDC staff have extensive diabetes knowledge with over 90 years of combined experience within the field of diabetes care.

Transition
As patients meet their goals and their condition stabilizes, they are transitioned to an alternate level of care such as a Diabetes Education Centre. The CCDC team works directly with an individual's primary care provider to ensure continuity of care and a coordinated approach to diabetes management and treatment.

Referrals to the Centre for Complex Diabetes Care  
Primary care providers wishing to make a referral to the Central LHIN Centre for Complex Diabetes Care  can enter their patient information into the electronic referral form or download and print a copy of the referral form and fax to 416-635-2601.
Centre for Complex Diabetes Care Referral Form (online only)
Centre for Complex Diabetes Care Referral Form (print and fax)

Contact us
Tel: 416-635-2575
Fax: 416-635-2601

Links
For further information about diabetes visit: