Preparing for your appointmentBy Mayo Clinic staff
Your child's family doctor or pediatrician will probably make the initial diagnosis of diabetes. However, you'll likely then be referred to 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). If your child's blood sugar levels are very high, your child's doctor may send your child to the hospital for treatment.
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 child's doctor.
What you can do
- Be aware of any pre-appointment restrictions. If your child's doctor is going to test your child's blood sugar, he or she may ask you to have your child refrain from eating or drinking anything but water for eight hours for a fasting glucose test or four hours for a pre-meal test. When you're making an appointment, ask if any type of fasting is necessary.
- Write down any symptoms your child is experiencing, including any that may seem unrelated.
- Ask a family member or friend to join you, if possible. Managing your child's diabetes well requires you to retain a lot of information, and it can sometimes be difficult to soak up all 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 child's doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For type 2 diabetes in children, some basic questions to ask your child's doctor include:
- How often do I need to monitor my child's blood sugar? At what times should I check?
- What is the goal range?
- What should my child's blood sugar levels be before bedtime?
- What types of changes need to be made in the family diet?
- How can I learn about counting carbohydrates in foods?
- Should I see a dietitian to help with meal planning at home?
- How much exercise should my child get each day?
- Will my child need to take oral medicine? If so, what kind and how much?
- Does the medicine need to be taken at any particular time of the day?
- Does my child need to take insulin?
- What types of insulin delivery options are available? Which do you recommend for my child and why? How should insulin be stored?
- What are the signs and symptoms of low blood sugar in my child?
- What are the signs of high blood sugar?
- Do I need to test my child for ketones? How is the test performed?
- What needs to be done if ketones are present?
- My child has another health condition. How can we best manage them together?
- How often does my child need to be monitored for diabetes complications? What specialists do we need to see?
- What does my child's school need to know about managing diabetes? What about summer camp?
- Are there any resources available if I'm having trouble paying for my child's diabetes supplies?
- Are there any brochures or other printed material that we can take home? What websites do you recommend?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions that may come up during the appointment.
What to expect from your child's doctor
Your child's doctor is likely to ask a number of questions, such as:
- Do you feel confident about your child's treatment plan?
- Any questions or concerns about his or her current situation?
- How do you feel your child is coping with the diabetes and its treatment?
- Has your child experienced any low blood sugars?
- What's a typical day's diet like?
- Is your child exercising? If so, how often?
- On average, how much insulin is your child using each day?
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 certified diabetes educator in between appointments for advice and guidance.
- Rosenbloom AL, et al. ISPAD clinical practice consensus guidelines 2009 compendium — Type 2 diabetes in children and adolescents. Pediatric Diabetes. 2009;10(suppl):17.
- 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.
- Standards of medical care in diabetes — 2011. Diabetes Care. 2011;34(suppl):1.
- Simms-Robinson C, et al. How does diabetes accelerate Alzheimer disease pathology? Nature Reviews: Neurology. 2010;6:551.
- Laffel L, et al. Management of type 2 diabetes mellitus in children and adolescents. http://www.uptodate.com/home/index.htm. Accessed Jan. 19, 2011.
- Ketoacidosis. American Diabetes Association. http://www.diabetes.org/type-1-diabetes/ketoacidosis.jsp. Accessed Jan. 14, 2011.
- Natural Medicines in the Clinical Management of Diabetes. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Dec. 2, 2010.
- Shapiro S, et al. The role of complementary and alternative therapies in pediatric diabetes. Endocrinology and Metabolism Clinics of North America. 2009;38:791.
- Copeland K, et al. Management of newly diagnosed type 2 diabetes mellitus (T2DM) in children and adolescents. Pediatrics. 2013;131:364.