My 11 year old is on Medicaid, and we are now waiting for pump approval. I am concerned about Medicaid not wanting to cover the higher cost of the specialist, but I want my son to get good care. His primary care physician isn’t educated well enough for such a serious disease. I was informed by his nurse that we didn’t need to see the specialist every time. Does my son need to be seeing the endocrinologist every three to four months, or how often?

If your son is starting on an insulin pump, you will need the expertise of a diabetes team for several months. Then perhaps, as the two of you become very familiar with the challenges of pump therapy (and of course the good points, too), you could see the team on an every three month basis. Especially with pump therapy, I think visits every three to four months to a pediatric diabetes team well versed in insulin pump therapy will prove invaluable.

LSF

[Editor’s comment: As Lois has stated, unless your son’s primary care physician is well-versed in the use of insulin pumps, it is essential that your son be followed by a pediatric diabetes team familiar with pumps at least in the beginning stages. If he does well, it may be possible for his primary care physician to follow him in concert with the diabetes team, consulting them for dose changes, etc. However, I would really push for the referral on a regular (at least every six months) basis.

SS]