Justin Delgado is husband to Kacie Doyle-Delgado, diagnosed at age 11. After more than a decade together, he considers himself to be an expert carb counter and Dexcom inserter. He graduated with his Master of Science in Finance from the University of Utah in 2013 and has been working in commercial banking since then. He attended his first Friends for Life conference in 2015 and is looking forward to volunteering with the teens.
October 2, 1999
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.