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January 27, 2000

Daily Care

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Question from Louisville, Colorado, USA:

My niece was diagnosed with Type 1 diabetes when she was 20 months old. She will be turning 4 years old in a few days. She lives in the New York metro area with easy access to New York City. Her current endocrinologist is a pediatric endocrinologist but due to the age she acquired the disease I worry about her 10-15 years down the line. Do you know of a facility or physician who might have worked or do work with type 1 diabetics that acquired the disease at such a young age? I am hoping to direct her to a physician that possibly will not continue to treat her as conservative as she is now.

Answer:

From: DTeam Staff

Most, if not all, pediatric endocrinologists have had extensive experience treating children who develop diabetes at very young ages. As you surmised, there are many experienced pediatric endocrinologists in the NY Metro area. It is hard to know exactly what you mean by “conservative” in diabetes management, but at the age of 4, blood sugars can bounce up and down no matter how hard you aim for strict control, and if you aim too hard, you can wind up with serious low blood sugars including seizures. There is growing evidence that too many serious low blood sugars at this age can increase the risk of learning disabilities later on in life. On the other hand, it is still important to aim for the best possible control.

It is best for your relatives to ask their pediatrician for a referral to a pediatric endocrinologist who works with their own pediatrician. If they want a second opinion, they can contact the American Diabetes Association for other names in the area or attend local Juvenile Diabetes Foundation or American Diabetes Association meetings and speak to other parents to learn the philosophies of the various pediatric endocrinologists in the area.

TGL