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November 8, 2008

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Question from Essex Junction, Vermont, USA:

Our child is a newly diagnosed type 1 diabetic. We would like to get a medical id that includes engraved information for our child and we like the idea of including a phone number. How do we choose from all the options we see out there, especially online? In particular, what is the difference between American Medical ID and Medic Alert? The cost difference between those is significant. Are there others out there to consider? What phone number should we put on the tag, too, and why? We have looked for this information online and have asked at the hospital/clinic and have not been able to get much, if any, input that helped there.

Answer:

From: DTeam Staff

There are a great variety of medical identification products available. As you consider your options, products like MedicAlert� offer a 24-hour call center to respond to calls from emergency medical staff, and that kind of service will add to the cost of their products. You have to decide whether that service is worth the additional cost compared with an engraved product.

JSH
Additional comments from Dr. David Schwartz:
A common and frustrating clinical situation when caring for the child (or adult) with diabetes, is the consistent wearing of medical identification. So big kudos to you for advocating for this and seeing the importance.

While having proper and helpful information on the medical identification is obviously important, equally (or more) important is having the child wear it. I do not know the age of your child, but we find it often difficult for teens to wear their medical ID. So here is my general advice to families as they choose medical ID:

I don’t care which company or which type of medical ID is chosen and there are many designs and companies, as long as the child wears it. I think the child, when age appropriate (and this includes very young children) should have some say-so. When they help choose their medical ID they then get some “ownership” and (I believe) are more likely to wear it.

I also think that the younger the child is when they start to wear ID, the less of a deal it is for them when they are older. Diabetic children are just like any child: they rebel as they age.

Don’t lose track of the purpose of medical ID: it is to be seen by emergency medical personnel and they typically will check for wrist bracelets and necklaces. Nevertheless, some ID is better than none, so if you have to choose an ankle bracelet or a tag to place on a toddler’s sneakers, that is acceptable, but not ideal. While you might want to choose medical ID that is “pretty,” like a charm necklace/bracelet — and these are great — keep in mind that if too small they can be easily overlooked. But if the grade school girl will only wear a charm necklace, then deal with that for now. But despite the objections of fashion conscious teens, I do advocate for something not so subtle.

I advocate for getting something not too expensive — medical IDs are commonly “lost” — purposefully or not. So don’t get a silver, gold, platinum ID for a child or teen, in my view. But I have had one or two teens who really showed off their “bling” medical ID!

The medical ID is more likely to get “lost” the more often it is removed – – even for reasonable reasons (such as bathing). So I say to just keep it on during showers, baths, swimming, etc.

The engraving often fades/erodes over time. Teen boys (and younger too) often prefer “dog tags” — but I wouldn’t choose a necklace for an infant or toddler because of the real, albeit rare, risk of choking if it gets caught on something. You can find wrist bands made of cloth that look like sweat bands; you can find wrist bands that are made of rubber/silicone that are popular with kids today (in the fashion of Livestrong or WWJD). But these all fade. Be prepared to buy more.

Also, many medical IDs will have some medical symbol — usually in red — as part of the design. This fades too. So I suggest that you paint a thin coat of clear enamel or nail polish/acrylic over the ID. If the ID does not have such a symbol, I advocate painting some red (again with nail polish and then a clear overcoat) to make things stand out a little.

The MedicAlert company, in my experience, will engrave virtually anything you want in the space available. I’d give as much info as needed. So I’d prefer “Type 1 diabetes” over “Diabetic.” Putting your phone number could be a double-edged sword in the goofy world we live in. So an advantage of MedicAlert is that they will do the calling as they’ll have your number(s) on file. Don’t forget to update them when you move. I’ve had patients who had their MedicAlert tag replaced for free by the company. I don’t know if this is the exception or the rule. Ask them.

But if patients can only afford a cheaper one from the kiosk in the mall, and the engraver can only fit “Diabetic,” again that is better than nothing. Some of the other mail order companies offer excellent options and, as noted, are less expensive than MedicAlert.

I’d also advocate for the older child or teen to carry a card in the wallet/purse that denotes some medical ID.

So, a few tips from the trenches.

DS