Q: My recently diagnosed 7-year old has only seen one pediatrician her entire life. But suddenly we have an entire "diabetes team" to take care of her type 1 diabetes. It's confusing. Just what is the role of each of these medical professionals? Who do I call when I have a question?
A: The multidisciplinary team assigned to the care of a child with type 1 diabetes is there to make sure children and their parents are equipped with all the tools they need to successfully manage the condition. And yes, this will mean encountering quite a few new faces at first. But those old familiar faces you've counted on over the years for your child's healthcare -- including your longtime pediatrician -- won't disappear just because of your daughter's diagnosis.
At the head of the team is usually a doctor called an endocrinologist -- an M.D. who specializes in the diagnosis and treatment of people with type 1 diabetes and other hormone-related conditions. However, the person with whom you may have the most frequent contact is a certified diabetes educator (CDE), a specially trained healthcare professional whose focus is on helping people of all ages with diabetes (and their families) understand the disease and how to successfully manage it. This person might work out of a hospital, diabetes clinic, or as part of a medical practice devoted to diabetic care. Your nurse or nurse practitioner, registered dietitian, exercise physiologist or other member of your healthcare team may be a CDE.
A CDE is a great resource when you are learning the day-to-day basics of how to keep your child's blood sugar level steady, including how to check blood sugar, count carbs, and administer insulin. Your CDE often serves as the main point person on your child's care team, there to check in on your child's progress, field your diabetes-related questions, and help make referrals to other members of the care team, as necessary. These other members often include a social worker, psychologist, or family therapist to address emotional needs related to type 1 diabetes. If your CDE and other care team members address your concerns with compassion, understanding, and practical advice, chances are you and your child are in good hands.
So if your child sees an endocrinologist, where does this leave your regular pediatrician? This is the person to call for any nondiabetes-related health issues, ranging from coughs and colds to your child's annual physical. A good way to bridge the gap between what can seem like two very different worlds in your child's life and care is to still keep your pediatrician up to speed on how your daughter is managing her diabetes. Likewise, if your CDE knows when your child has a cold or the flu, he or she can offer advice on how to keep blood sugar levels stable until your child feels better.
--Gary Scheiner is a certified diabetes educator, exercise physiologist, and founder of Integrated Diabetes Services in Wynnewood, Pennsylvania. He's had type 1 diabetes for more than 20 years.
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.
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