Regular Endo or Pediateric Endo

Hi there!

I am mom to Dave. He was diagnosed 12/2/2008. We’ve made it to the year mark however I’m having some worries that I’m not doing what’s best for David. We live in a very rural town. When he was diagnosed luckily we were in a larger city which is about 90 miles away from us. They have and endo office that serves our region (SE idaho, montana, wyoming). We really like our Endo and CDE and I feel like they do a good job. However often there are still lots of questions that I come up with all the time. I try to keep track of them but never think to ask them at appts. We can call when we want to talk to Dr. or CDE and I felt like we were in good care.

However there is another mother in our community who has a T1d child that travels to Salt Lake City to their pediatric endo. Every time I see her, all I hear about is how bad our Endo is, how much she hates him and how wonderful the Endo is down there. I have family in SLC so if necessary we can travel (300 miles) to appts and stay with family but I wonder how important is it to see a pediatric endo? She kept telling me that I just don’t know what I’m missing because I haven’t been to see them (ped. endo). Usually I just listen to her as a friend and then stick with what we have because it seems to be working.

However this last time I talked to her I cam away feeling like a terrible mom. Our last a1c was 8 (up from 6.4). I keep thinking what if I’m not doing everything I could by not finding a pediatric endo? Am I being selfish in thinking things are fine with our regular endo?

I guess what I’m asking is, we live far enough away that we’ll be crossing state lines and could have insurance issues if we switch. Do you use a pediatric endo or regular endo, have you done both, or are there resommendations as to why I should consider switching.

I know that it’s my sons health, but I feel comfortable with our current situation, I think he’s a good man and good in his practice. Because I have questions though do you think I’m not informed enough as a mother about diabetes and that by switching it would be better for David?

Sorry it’s so long winded, I’m just frustrated about this topic that keeps coming up between this woman and I.

The difference is that peds specialize in Type 1 usually. When I switched after I turned 19, it took me a while to get my endo on the “type 1” wavelength, since the majority of her paitents are type 2

However, if you’re happy with your team I dont’ see any reason to switch.

I lived in small town America when I was diagnosed (age 11) and so my parents and I traveled a little over an hour to visit a pediatric endo. When I turned 16 or 17, I started seeing an adult endo. I thought both were great, but the pediatric endo actually had relatively odd bedside manner (super smart guy, but I think he had trouble relating to people b/c he was so smart…). I don’t necessarily think that the pediatric endo was more equipped than the adult endo (in my case, they both saw about the same amount of T1). However, if you feel like your son’s A1c goals are not being met, or if you feel like ‘the grass is greener’ on the other side, then maybe take one or two visits to travel and see the pediatric endo. If it doesn’t work out, or if you’re not getting any results, it’s not the end of the world to switch back.It sounds like you’re comfortable w/ the current situation, so it might be best to let it be for now. You may always have disagreements on the best option when talking w/ the other mother w/ the T1 child. I think there are different strokes for different folks (even down to something as simple as when to change your lancet…some people, only a few times a year. Some people, every time they go to test). As long as your son is healthy and both of you (and your family) are happy, then I think you’re fine. You’re a mother who is obviously concerned for your son–of course you’re going to have questions :slight_smile: I would say keep up the good work and don’t worry about what the other mother thinks.

Just my $0.02… I don’t have a good answer for you as my 4-year-old son is only 9 months out from diagnosis too… just a little alternative experience that may or may not be helpful.

We are VERY blessed to live in the Denver area and have health insurance that covers clinical visits for my son at the Barbara Davis Center for Juvenile Diabetes Research.

Tyler’s Endo is part of the BD center and therefore clearly a leader in the field of Type 1 for kids.

Now - taking all that in… my point in making this post was to say… there are still questions that these leading experts cannot answer for us. There are times when I definitely feel like it’s this process of “well, let’s try this…”. I’m a computer geek by trade and therefore I seek straightforward logical answers to problems - one of my hurdles as a father has been dealing with the fact that Juvenile Diabetes really just doesn’t work this way. There are simply too many variables.

Obviously I can’t decide if your “country endo” is good enough for your child - but perhaps there are times when it seems like he doesn’t know the answer because there actually isn’t one.

Our Endo serves a broad area so he sees a good amount of Type 1, but it isn’t something I thought of that he sees both T1 and T2.

Bradford, thanks for the insight. We would be traveling about 5 hours to see a pediatric endo vs. 1.5 hours for our regular endo. I am comfortable with the current situation except for when I talk to the other mom, so naturally I start questioning myself. I do feel like we have very different parenting styles so her Dr. might not be the right fit for us, but just worry that just because I am comfortable with things, doesn’t mean that it couldn’t be better. Thanks for the encouragement and positive re-enforcement. Its nice to hear someone who has been through it as I’m just the mom, not the one really dealing with it myself.

I don’t think it would make a difference that is worth 5 hours,though it totally depends on the current situation.I mean,if you’re not comfortable with the Medication plan,then you may change,it would really help to try the ped endo for a while,if you see that he is planning to use the same plan,then no need to change…
hope it helps

Pediatric endos typically specialize and have a greater understanding for diabetes in chiildren. Adult endos tend to be a bit more strict about diabetes management.

If it works for you, there is no reason to spend 3 hours to go see a doctor if you don’t think it will help. If you are unhappy, then go switch. Some people get really passionate about their care and want everyone to be just like them! But it isn’t always like that. We all have our own preferences for doctors, meters, pumps, etc. It’s up to you to decide what’s best for your son until he’s old enough to contribute his own thoughts.

Hope that helps!

I would say that I would stick with the doctor that you have now and not worry about it. It is hard to find a good doctor that you actually click with and you feel good about. Just because a doctor is specialized in pediatrics does not make them a better doctor for your son.

I would just tell the lady that your insurance will not cover your son seeing that doctor.

I keep a special notebook that I write down my questions on so that I can remember to ask them at the doctor appt.