Preparing for your appointmentBy Mayo Clinic staff
Your child's family doctor or pediatrician will probably make the initial diagnosis of diabetes, and possibly send your child straight to the hospital. There, the staff will stabilize his or her blood sugar levels, and you and your child will learn about insulin delivery, carbohydrate counting and more. Diabetes education may also be done on an outpatient basis if your child's condition is stable.
Once your child is discharged from the hospital, his or her diabetes care will likely be handled by a doctor who specializes in metabolic disorders in children (pediatric endocrinologist). Your child's health care team will also generally include a dietitian, a certified diabetes educator, and a doctor who specializes in eye care (ophthalmologist).
Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to be well prepared for any appointments you have with your child's health care team. Here's some information to help you get ready for your appointment, and what you can expect from your doctor.
What you can do
- Write down any concerns you have about your child's well-being that you want to share with your doctor.
- Ask a family member or friend to join you, if possible. Managing diabetes well requires you to retain a lot of information, and it can sometimes be difficult to understand and remember all of the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
- Take a notebook and a pen or pencil, to write down important information.
- Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions that can help you clarify aspects of your child's care can be useful. Some of your concerns may be best addressed by a dietitian or a diabetes nurse educator. Ask your doctor for a referral. For type 1 diabetes in children, some topics you may want to address with your doctor, dietitian or diabetes educator include:
- The frequency and timing of blood glucose monitoring
- Insulin therapy — types of insulin used, timing of dosing, amount of dose
- Insulin administration: shots versus pumps
- Low blood sugar — how to recognize and treat
- High blood sugar — how to recognize and treat
- Ketones — testing and treatment
- Nutrition — types of food and their effect on blood sugar
- Carbohydrate counting
- Exercise — adjusting insulin and food intake for activity
- Dealing with diabetes at school, at summer camp and on special occasions, such as sleepovers
- Medical management — how often to visit the doctor and other diabetes care specialists
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
- How comfortable are you managing your child's diabetes?
- Has your child had any low blood sugar episodes?
- What's a typical day's diet like?
- Is your child exercising? If so, how often?
- On average, how much insulin are you using daily?
What you can do in the meantime
If your child's blood sugar isn't well controlled, or if you're not sure about what to do in a certain situation, don't hesitate to contact your child's doctor or diabetes educator in between appointments for advice and guidance.
- Standards of medical care in diabetes — 2011. Diabetes Care. 2011;34(suppl):1.
- Your guide to diabetes: Type 1 and type 2. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/type1and2/. Accessed Jan. 10, 2011.
- Diabetes mellitus. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec12/ch158/ch158b.html#sec12-ch158-ch158b-1105. Accessed Jan. 13, 2011.
- Shulman RM, et al. Type 1 diabetes mellitus in childhood. Medicine. 2010;38:679.
- Knip M, et al. Dietary intervention in infancy and later signs of beta-cell autoimmunity. New England Journal of Medicine. 2010;363:1900.
- de Paula FJA, et al. Novel insights into the relationship between diabetes and osteoporosis. Diabetes and Metabolism Research and Reviews. 2010;26:622.
- Sims-Robinson C, et al. How does diabetes accelerate Alzheimer disease pathology? Nature Reviews: Neurology. 2010;6:551.
- Levitsky LL, et al. Management of type 1 diabetes mellitus in children and adolescents. http://www.uptodate.com/home.index.html. Accessed Jan. 10, 2011.
- Levitsky LL, et al. Complications and screening in children and adolescents with type 1 diabetes mellitus. http://www.uptodate.com/home.index.html. Accessed Jan. 10, 2011.
- Ketoacidosis (DKA). American Diabetes Association. http://www.diabetes.org/type-1-diabetes/ketoacidosis.jsp. Accessed Jan. 14, 2011.
- Shapiro S, et al. The role of complementary and alternative therapies in pediatric diabetes. Endocrinology and Metabolism Clinics of North America. 2009;38:791.
- Collazzo-Clavell M (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 19, 2011.
- Types of insulin. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/insert_C.htm. Accessed Feb. 24, 2011.