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Question: From a nurse in Marietta, Georgia, USA: My 40 year sister has had type 1 diabetes for 37 years. At the time she was diagnosed our local pediatrician worked closely with a nationally-known Clinic concerning management of her care. She has end-stage retinopathy in one eye, paresthesias [uncomfortable feelings] in all extremities, and has recently experienced serum creatinine levels of 2 mg/dl. As a nurse, I want to be sure she is availing herself of the most progressive complication management possible. Her care is coordinated by an internist nearby. She also sees a neurologist, endocrinologist, nephrologist and an ophthalmologist. I referred her to a nearby School of Medicine for a consult, but she was not satisfied with access to the physicians. Do large centers provide consultations to adults like my sister? She has two children, 14 and 6 and so complication management, coordination of care and quality of life are major concerns. Answer: Presumably, as in the UK, a patient has a right to a 2nd opinion, and could be referred to an alternative centre. With the patient having multiple problems, the care needs to be carefully coordinated by a competent diabetologist, and be able to involve the appropriate specialists experienced in dealing with diabetic complications. In the UK, if a patient was unhappy with their care, they would be referred for another opinion. JS DTQ-19990627210012 Original posting 2 Oct 1999 Posted to Daily Care

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			Jump to a new section --[ Getting Around ]-- Home Page What's New Privacy Policy Search --[ People ]-- Family Support Network Adults with Diabetes Care Photos Chat Rooms Conferences Kids with Diabetes Parents Parent Humor Scholarships and Financial Aid Grandparents Humorous Tidbits Jobs Mailing Lists CWD Forums Poetry and Art Videos Polls Quilt for Life Surveys Blogs --[ Clinic ]-- Ask the Diabetes Team Alternate Site Testing Alternative Treatments Care Suggestions CWD Español Diabetes Basics Diabetes at School 504 Plans Diabetes Camps Diabetes Dictionary Insulin Pumps Nutrition Podcasts Presentations Products Product Marketplace Sports Studies Warning Signs --[ Sources ]-- News and Information Diabetes Advocacy Links to Other Web Sites Press Releases Regional Information Services Support Groups --[ Feedback ]-- About CWD Advertise Awards Contribute Your Experiences Disclaimer Letters to the Editor Logos and Linking Share our Brochures

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