Doing Key Tests at the Doctors Office

Treating your child's type 1 diabetes (or T1DM for short) means that his doctor must order many tests, but as a responsible parent, you shouldn't depend on the doctor's memory to make sure the tests are done. After all, he's a busy guy with hundreds of patients to worry about. Instead, keep a flow chart for your child's tests and fill in the blanks as time goes by. I've created such a chart for you on the Cheat Sheet at the front of this book. Copy it and use it to make sure that your child's tests get done at the appropriate times.

Following are the tests that must be done on a regular basis to evaluate the status of your child's diabetes (I go into detail on them in the following sections):

i The doctor should download your child's blood glucose results from the home glucose meter at every office visit into a computer program that he can use to adjust treatment. (I discuss home meters later in this chapter in the section "Selecting a Home Blood Glucose Meter.")

i You should examine your child's feet daily; the doctor should examine your child's feet at every office visit.

i The doctor should measure the blood pressure at each visit.

i Your child's height and weight should be measured at each visit.

i The doctor should send your child to the laboratory for a hemoglobin A1c test every three months. You can also do this test at home and give the results to the doctor.

ii The doctor should do an ankle-brachial index study every five years.

i The doctor should check the thyroid function with a TSH at the beginning of treatment and every five years thereafter.

i The doctor should order an annual microalbuminuria test to look for early kidney damage.

i The doctor should send your child to an ophthalmologist or optometrist for an annual dilated eye examination.

i The doctor should order an annual lipid panel on your child.

If any abnormalities are found in these tests, the frequency of testing is increased and steps are taken to reverse the abnormalities.

If you want more information on every aspect of proper diabetes care for your child, go to the Web site of the National Diabetes Education Program at ndep. There you can find information for parents and children including standards of care. Another great resource for parents is the Web site Better Diabetes Care at htm. Although this is a site for professionals, it tells you what your child's doctor should be doing for your child to provide the best diabetes care possible.

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