START Transition Program

START Adolescent Transition Program

(757) 668-8609

The START adolescent transition clinic has been created to assist diabetic patients who are 15-21 years of age as they transition to seeing an adult endocrinologist. It is the goal of our team to provide our patients with the resources and tools to achieve independence in care.


We feel it is important to start discussing this transition at an early age so that patients know what to expect and have the knowledge they need to stay healthy and independently manage their diabetes before aging out of our pediatric practice.

Our START program includes two nurse practitioners, three diabetes educators and a medical social worker. Patients are seen in our clinic

twice by their designated nurse practitioner to assess their readiness for transition and twice by a certified diabetes educator to receive transition related education/guidance.  During these education visits, patients will also meet with our medical social worker to receive support and assessment of financial and mental health needs.

Once their primary endocrinologist identifies that the patient is ready to move onto an adult endocrinologist, the nurse practitioner will assist in coordinating transition to the selected adult endocrinologist.

Where To Find Treatment for Depression and Other Mental Health Needs

  • Contact the Diabetes Center at CHKD and ask to speak to a social worker: (757) 668-8609
  • If you have health insurance, contact your insurance provider to obtain a list of covered mental health professionals in your area. 
  • EVMS Outpatient Training Clinic for Mental Health (provides psychotherapy by interns under supervision for only $10 per session. Does not accept Medicaid/Medicare patients.)
  • Access Partnership
(757) 668-8609


  • Paula Raube, CPNP, medical provider, program director (757) 668-7237
  • Lauren McMichael, CPNP, medical provider (757) 668-7237
  • Renee Freeman, RN, CDE, educator (757) 668-7695
  • Shawnee Sweeney, RD, educator (757) 668-9558
  • Karen Ulerio, LCSW, medical social worker (757) 668-9138

Other important contact information

  • Diabetes Center, (757) 668-8609
  • Main Endocrinology number, (757) 668-7237
  • CHKD Endocrinology Emergency line, (866) 883-9886          
  • Prescription line, (757) 668-8747