Part of the baptism into the world of type I diabetes is the realization that all doctors are not created equal. Ask a dozen doctors the same specific question about diabetes management and there’s almost a 100% guarantee that you will get back 12 completely different and conflicting answers.
Most medical students receive minimal instruction and training in regards to juvenile diabetes while at medical school. Only those that are being trained to practice in the field of Endocrinology are given in depth training and instruction about the disease. Because of this, it is always of the utmost importance to be under the care of a competent endocrinologist along with your regular family physician.
When my son was first diagnosed, his pediatrician insisted that she would handle his diabetes management and that there was no real need for him to be seen by a pediatric endocrinologist except for quarterly visits. I incorrectly assumed that she knew what was best and relied on her to get us through the first few difficult weeks after his diagnosis. It came up during a conversation with her that she had no idea how much a specific amount of carbohydrates would raise blood sugar. I thought it odd that she could manage the complicated management when she obviously didn’t know the basics about the disease. When I expressed my fear of night time hypos, she belittled my fears by telling me that ‘so what if he has a seizure, they don’t last long…’ I seriously doubt that she would have been so nonchalant if we had been discussing the possibility of her child having a hypoglycemic seizure rather than mine. Needless to say, I fired her, removed my son’s records from her office and found another, more competent pediatrician and put my son back in the care of a pediatric endo.
The first pediatric endocrinologist had the training and background needed but I found his bedside manner lacking and he had the personality of an empty milk jug. He knew all the textbook answers but he simply had no idea of the reality of what a day in the life of a young child with juvenile diabetes is actually like. He pushed for a constant level of 80-130 which is fine for an adult but dangerous for an overactive 6 year old. He refused to listen to any explanations of why I felt uncomfortable with the levels he insisted on and repeatedly preached to me the results of the DCCT. When I questioned him as to how many 6 year olds had been a part of the DCCT he suggested I was being facetious and I went in search of another pediatric endo.