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Re: [IP] check-ups


The guidelines I published can be modified for children. Certainly the timing 
for HgbA1C, blood tests (lipid, chemistry, urine), and eye exam should be the 
same. They probably check her B/P and other basic vital signs at each visit. 
There are many pediatricians who favor checking lipid profiles in children 
who are obese, or with a strong family history of heart disease, even if they 
do not have D. If a child has D it makes sense to check them for possible 
complications at the same timing intervals, (although their youth probably 
does offer some protection for a longer period than an adult).
As for the feet, I try to remind my daughter to check her feet every day to 
get her in the habit now. If a person with Diabetes has full feeling in 
his/her feet, then chances of a sore or infection getting overlooked are low. 
The doctor/nurse should do a thorough foot exam once a year which includes 
testing for loss of feeling. The foot inspection I listed every visit is 
really a visual check for sores or infections, etc.
I would be sure to try to at least get a baseline dilated eye exam, with 
retinal photos, and a lipid profile by the time of her 5th anniversary date 
of diagnosis.
My daughter, 14 and diagnosis 3/97, just had her 1st eye exam and she has 
tortuous vessels in her retina already. Although this may be a normal variant 
(the opthamologist said "we see that in diabetics and some people without 
diabetes"),as a medical professional I am aware that it is also associated 
with "older" blood vessels.
I was certainly glad my insurance allowed us to get this exam even though she 
had not reached her 5 year mark yet. I wish I had a baseline retinal photo 
though to compare.
Sorry I got carried away with the answer. Just a mom to mom concerned about 
our children answer.
So yes, I would push the insurance company.
Good luck.
Joann (mom to Cara age 14)
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