Peds Outpatient

I am currently shadowing an outpatient peds dietitian. She is also a CDE, and this is what most of her work involves; a few days a week she will see one or two non-diabetes patients. She also has Type I diabetes, I feel like this of course gives her a special edge working with these patients. In the past two days we have seen 3 teens for weight management and one for gluten free diet (she gets a lot of these apparently, and apparently it is very prevalent in children with diabetes too, since they are both autoimmune diseases). The rest of the patients have been diabetes patients, mostly type 1, so most of what she does is with insulin regimens, and not so much with diet. There is diabetes clinic every afternoon and insulin pump training two mornings a week. Today was the training for spanish speaking patients and I must admit it was a little hectic. The lady who was presenting today was a little disorganized and everything had to go through the interpreter (for the parents, all the kids spoke english) so it took about 4 hours. But I now know how to set up a pump and get the catheter in and the tubing set up!

We saw the cutest 3 1/2 year old boy today, and his parents were so on top of his newly diagnosed diabetes, it was inspirational and apparently very out of the ordinary. They carried around a carb counting book and measured all his food on a scale. However, many of the other cases we have seen have been less than inspirational, mostly involving 16-17 year old boys with extremely uncontrolled type I. Today the doctor threatened to hospitalize one patient if he didn't get it under control, his HbA1c was over 14. Yesterday, a boy got his driver's license revoked and DSS was called due to a lack of control over a long period of time. They call DSS if patients can't get it under some semblance of control b/c they are minors and their parents are still supposed to be responsible for their care.

Tomorrow is another insulin pump class, so I'll get even more familiar, especially since it will be all in English...