Lg Cwd
Need Help

Submit your question to our team of health care professionals.

Current Question

See what's on the mind of the community right now.

Meet the Team

Learn more about our world-renowned team.

DTeam Archives

Review the entire archive according to the date it was posted.

October 2, 1999

Daily Care

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.


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.