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[IP] Re: What a CDE/endo does at the office visit?

 In a message dated 11/27/2003 6:32:39 PM Eastern Standard Time,
email @ redacted writes:
> Anyone want to share details of what their endo/CDE does at the office visit?
> Laura G.


 I've been a type 1 diabetic for close to 47 years; until recently I always saw
the family doctor for my diabetes management. Most of these have been fairly
decent doctors who know more about diabetes than most. But I had a terrible time
keeping my blood sugars under control and had an especially strong dawn
phenomenon. No one had ever suggested that I see anyone else and I had never
heard of an endo or CDE prior to 1999.

 After trying everything under the sun (or so we thought) to get my blood sugars
more consistent and in line, my current PCP finally suggested in 1999 that I go
to a newly established diabetes center at a local hospital. It was there I met a
CDE and a dietician who have since become two of the most important and helpful
people I've ever known. First they introduced me to the pump which of course
changed my life.

 They always have me keep a very detailed diary of blood sugar readings with all
food intake, insulin dosages, stress level, activity level, any sickness, and
anything else that may affect my bg's. At each visit, they review my diary day
by day, ask certain questions, and try to help me analyze the effect certain
things have. Then they make certain suggestions about things to eat or avoid,
basal increases/decreases, etc etc; and we make realistic goals for the next
period of time before I see them again. At each visit we also discuss how well I
met each of the previous goals and the reasons why or why not.

 Additionally they make me aware of new products available or "in the works."
Also I have their email addresses and pager numbers that I can use at any time I
need their help.

 I have a real problem trying to keep the detailed records (even though I'm an
accountant-lol), but I have terrible time constraints so I probably need to get
a PDA or something to help me along those lines; however I do manage to get it
done for my CDE visits.

 I saw an endo for the first time in October; I was not impressed with him at
all. He basically reviewed my records and told me I was doing a fine job, keep
up the good work yadda. yadda, come back in January. However since that visit, I
learned that he is the chairman of the diabetes center where I see the CDE and
dietician! - lol. I think it remains to be seen whether I will develop a close
trusted relationship with him.

 You really need a doctor and/or CDE who will do something to help you manage
your diabetes care; otherwise what is that point?

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