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Question:

From Louisiana, USA:

We live about an hour from my son's pediatric endocrinologist. My son is 15 and has been a diabetic for 4 years. My education for diabetes was not (in my opinion) the best. I did not learn about ketones until much later into his diabetes. Anyway, when my child with diabetes gets sick who should I call: his endocrinologist or regular doctor? The doctors here do not want to fool with my son because he is a diabetic plus they know he sees someone else and they do not want to overstep their bounds. Therefore when he is sick I call his endo doc. Today he said that is wrong; I should not bother him with an upset stomach and should be handled by his regular physician. I do not feel comfortable letting anyone else treat him, plus no one would want to. How should this be handled? Do I need to look for a new family doc or new endo doc?

Answer:

As a parent of a child with diabetes, I sympathize with your problem. We were very fortunate in that our daughter was diagnosed by our general pediatrician and welcomed to return with any non-diabetic-related condition.

Your pediatrician should be willing to treat routine illnesses that might occur in your diabetic child. If this is not the case, my recommendation would be to get a new pediatrician.

HVS

Additional comments from Dr. Deeb:

Consultant and primary care physicians need to establish job descriptions. The endocrinologist, an hour away, is really too far to be a primary care physician to your child (yet I frequently seem to end up in the primary role too!). I like it best when the kids have a caring pediatrician who is willing to take care of the illnesses at home and call me when needed. It seems best for the child to me. Such pediatricians exist.

LD

Additional Comments from Dr. Lebinger:

I agree that most pediatricians should be able to diagnose and treat common childhood illnesses in a child with diabetes. If the blood sugars are running higher or lower than usual, if there are ketones in the urine, if medications are prescribed which affect the blood sugar (i.e., asthma medications, especially prednisone or other steroids) or if the illness interferes with eating, you or your pediatrician should also contact your pediatric endocrinologist to discuss how to adjust the insulin and/or food.

TGL

Original posting 9 Aug 1998
Posted to Daily Care

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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