Tuesday 26 July 2011

It's Not About the Numbers

Last Friday was Dylan's quarterly diabetes checkup with the team of caregivers. I've often wondered how diabetes checkups are done with other endocrinologists; ours has kind of a different approach I think.

Every 3 months we see the endo at what our local hospital calls the "Diabetes Education Center," which is essentially a wing of the hospital comprised of a large classroom and a few smaller, private rooms. Our stay lasts anywhere from as little as 45 minutes to as long as two hours and in that time we meet with at least 3 different individuals. A dietician is available to weigh and measure Dylan, take his blood pressure and talk about any changes in diet and/or activity level; a diabetes nurse does Dylan's A1C test, uploads Dylan's pump data to a software program to evaluate the numbers, and answers general health questions or issues; and the endocrinologist evaluates the numbers, both from the pump and the A1C, talks to us about changes, both good and bad, and adjusts Dylan's basal rates, carb ratios, or insulin sensitivity factor, if needed.

After we see everyone, there is always an educational session led by one of the individuals from the medical team. Topics vary from advanced pumping, to traveling with diabetes, to what to do when sick, among other topics. And then there are always a few other people there too. Last week our medtronic rep was there, as well as a medical student from the local university.

Together this amazing medical team provides a well balanced approach to diabetes that covers all aspects. But I think everyone's favorite part of the quarterly visit is the chance to sit and talk with other parents of type 1's. The appointments are scheduled by sex and age, so when we go, any other type 1 patients who are boys between the ages of 9 and 12 are also there. This is such a great opportunity not only for me to talk to other parents, but for Dylan to talk to other kids his age who have diabetes, an opportunity he doesn't get too often.

For the record, his A1C was 7.8. A bit higher than I would like, but an improvement over his previous one of 8.2, and the best A1C he's had in almost 2 years. The endo was happy to see it moving in the right direction, and it long as it continues to go down over the next few visits, I'm happy with it too.

So how do diabetes checkups work where you live? Do you see the endo alone, or is this team approach the norm?

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