Your child will be cared for by a team of diabetes care specialists; each member will play an important part in managing your child’s diabetes. Your team will consist of:
- you, your child, and your family
- a doctor who specializes in pediatric diabetes
- a diabetes nurse, who will plan and coordinate your teaching program, help you with the different skills needed to manage diabetes, and help you solve problems over the first few months and years
- a dietitian, who will help you and your child with meal planning, taking into account ages, stages and lifestyle issues
- a social worker, who will help you adjust to the various challenges that you might face at first and over the years
- a psychologist, when needed.
Other health-care professionals may join the team if their help is needed.
Clinic visits
Routine clinic visits are a time to review diabetes management. They will occur every three months. Visits will focus on diabetes-specific and general health issues, including some of the following:
- Insulin requirements; you will review frequency, injection sites, timing of injections, types of insulin, and doses with your diabetes team
- Meal planning; with the diabetes team, you will revisit your meal plan, including eating attitudes and behaviour, particularly in adolescents
- Results of blood glucose (sugar) levels, including hemoglobin A1c results
- Any symptoms, frequency, and treatment of low blood sugar and high blood sugar
- Exercise and other activities that affect blood sugar control
- Growth and development
- Attitudes and behaviours, including school attendance
- Lifestyle issues, including current activities, sleeping in, smoking, alcohol use, sexual activity
- Current and anticipated challenges in living with diabetes and coping with diabetes management
- Updating and/or clarifying goals and expectations
- Ongoing education––for parents, children, and teens—to learn new skills, concepts and management measures, and to review important principles and practices
- Screen for other illnesses that might occur with diabetes
The physical checkup generally includes the following:
- Height and weight measurements to make sure that your child is growing well
- Blood pressure measurements
- Assessment of the thyroid gland (in the neck) looking for signs of enlargement
- Examination of insulin injection sites for bumps and lumps
The regular visits also provide you and your child with the opportunity to learn more about diabetes and become more confident in your ability to make your own routine adjustments. The diabetes team can also help identify any potential personal issues that may affect diabetes management, or vice versa, and begin to deal with them.
The needs of children with diabetes change as they age. This is why it helps if you and your child can continue to meet diabetes team members from time to time.
Getting the most out of the visit with your health-care team
Over the years, the family dealing with diabetes will become quite familiar with the health-care system. Some people take a while to become comfortable working with health-care professionals. Remember that the diabetes team is there for your family. Here are some tips on how to get the most from your health-care team.
| Tips to get the most out of the visit with your health-care team | |
|---|---|
| Before the visit | Write out questions and concerns so you will not forget things |
| Write down any recent symptoms. | |
| Keep your blood sugar record book up to date. | |
| Know your child's previous HbA1c results. | |
| During the visit | Bring the blood sugar record book and the glucose meter. |
| Request time to ask questions. | |
| Write down the answers. | |
| Repeat answers back to the health-care-provider to make sure you understand. | |
| Make a specific plan of action for any changes to the diabetes routine. | |
| Make an appointment for the next visit. | |
| After the visit | Decide how to implement the changes. |
| Tell the rest of the family. | |
| Encourage your child to keep a diary to help keep track of the routine. | |
| Phone to get results from any screening tests, if your health-care provider gives out results by phone. | |