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Preparing for your appointment
By Mayo Clinic staffYour 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 nutritionist, a certified diabetes educator, and a doctor who specializes in eye care (ophthalmologist). If your child's blood sugar levels are very high, your 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 doctor.
What you can do
- Be aware of any pre-appointment restrictions. If your doctor is going to test your child's blood sugar, he or she will 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 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.
- Bring 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 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 doctor include:
Glucose monitoring
- 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 bed?
Lifestyle changes
- What types of changes do we need to make to our family's 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?
Medications
- Will my child need to take 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?
Complications
- What are the signs and symptoms of low blood sugar?
- How do I treat low blood sugar? How long should I wait before I retest?
- What about high blood sugar — what are the signs and symptoms?
- When should we test for ketones, and how do we do it?
- What do we do if ketones are present?
- My child has this other health condition. How can we best manage them together?
Medical management
- 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?
- What precautions do you suggest I take if my child goes to a friend's house for a sleepover?
- Are there any resources available if I'm having trouble paying for diabetes supplies?
- Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
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:
- 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 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.
- Laffel L, et al. Epidemiology, presentation, and diagnosis of type 2 diabetes mellitus in children and adolescents. http://www.uptodate.com/home/index.htm. Accessed Jan. 6, 2009.
- Am I at risk for type 2 diabetes? National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/DM/pubs/riskfortype2/. Accessed Jan. 9, 2009.
- Standards of medical care in diabetes — 2008. Alexandria, Va.: American Diabetes Association. http://care.diabetesjournals.org/content/vol31/Supplement_1/. Accessed Jan. 6, 2009.
- McCulloch DK, et al. Pathogenesis of type 2 diabetes mellitus. http://www.uptodate.com/home/index.htm. Accessed Jan. 6, 2009.
- Laffel L, et al. Comorbidities and complications of type 2 diabetes mellitus in children and adolescents. http://www.uptodate.com/home/index.htm. Accessed Jan. 6, 2009.
- McCulloch DK, et al. Glycemic control and vascular complications in type 2 diabetes mellitus. http://www.uptodate.com/home/index.htm. Accessed Jan. 6, 2009.
- Kidney disease (nephropathy). American Diabetes Association. http://www.diabetes.org/type-2-diabetes/kidney-disease.jsp. Accessed Jan. 9, 2009.
- Prevent diabetes problems: Keep your eyes healthy. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/complications_eyes/index.htm. Accessed Jan. 6, 2009.
- Why taking care of your diabetes is important. National Diabetes Information Clearinghouse. http://www.diabetes.niddk.nih.gov/dm/pubs/type1and2/care.htm. Accessed Jan. 9, 2009.
- Prevent diabetes problems: Keep your feet and skin healthy. National Diabetes Information Clearinghouse. http://diabetes.niddk.nih.gov/dm/pubs/complications_feet/. Accessed Jan. 9, 2009.
- Estimated Average Glucose, eAG. American Diabetes Association. http://professional.diabetes.org/GlucoseCalculator.aspx. Accessed Jan. 6, 2009.
- Laffel L, et al. Management of type 2 diabetes mellitus in children and adolescents. http://www.uptodate.com/home/index.htm. Accessed Jan. 6, 2009.
- The basics of insulin. American Diabetes Association. http://www.diabetes.org/utils/printthispage.jsp?PageID=TYPE1DIABETES3_263601. Accessed Jan. 6, 2009.
- Hypoglycemia. American Diabetes Association. http://tracker.diabetes.org/hypoglycemia.php. Accessed Jan. 9, 2009.
- Hyperglycemia. American Diabetes Association. http://tracker.diabetes.org/hyperglycemia.php. Accessed Jan. 9, 2009.
- Ketoacidosis. American Diabetes Association. http://www.diabetes.org/type-1-diabetes/ketoacidosis.jsp. Accessed Jan. 6, 2009.
- International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1.
