From the two stories that were just posted, from Michel and Harold, one thing struck me. I just wanted to make this a separate post so as not do dilute their stories. This just drives me nuts.
All the things they always do every single time you go into a doctor’s office or emergency room - measuring you, weighing you, taking your blood pressure, listening to your heart, listening to your breathing - every single time! Last time I was in an ER I had dislocated my finger, it was bent into an “S” shape, only backward of how a finger should go, and they are weighing me. It’s not my weight people! Look at my horribly disfigured finger!
But of all the things they do, why in the world would the doctor not check a kid’s BG?!?! It’s such a simple easy thing to do. BG testers are so cheap and easy to use. That could have saved both of those boys a few days of struggle. A BG tester is about the same cost as a stethoscope.
I bet so many childhood diagnoses have a similar theme - a delayed diagnosis, and a return a few days later.
I simply don’t understand why doctors don’t check BG as a common diagnosis tool. Especially when a kid is losing weight and peeing a lot.
I agree with Eric. I don’t understand why either. I feel that we were very lucky my kid’s diagnosis did not end in our kid’s death, due to my stupidity in not seeing what was obvious in front of my eyes. But it is galling that, with an A1c of 12.5%, and in the midst of losing several pounds per day, it took 3 medical visits in a week for him to get diagnosed.
Because my son was possibly 12-24 hours from death when diagnosed, I think that the lack of awareness of diabetes as a diagnosis, and the lack of use of a simple glucose meter when there is any doubt, likely result in a higher death rate than necessary for undiagnosed diabetic children.
What do you think it would take to get BG testing to be more mainstream? I think it was Britt who posted a link about more kids being diagnosed now. Why do they do those other checks, but not BG?
If a child comes in with what parents think is a flu, or an ear infection, or a stomach bug, what can we do to get doctors to simply check BG? If the test turns up nothing, it has only cost them a minute and a couple of dollars or a strip, and a little ouch on the kid’s finger. There is absolutely no downside to doing a check, even if it is not needed.
I guess part of the answer would be a cost analysis, however cold it sounds. How much would it cost to the industry to do a BG test every time a kid come in? Do you get the money back and more in early diagnosis? And is it likely that the little ouchie frightens many kids from coming to the doctor’s when they really should, making it harder on their parents?
My guess at these answers, not knowing any better:
We should not do a BG test every time a kid comes
we should do a BG test every time a kid comes with a certain set of symptoms. I am not 100% sure what the symptoms should be, but they should certainly include unexplained weight loss, sudden change in behavior at school or home, loss of energy, large increase in eating or drinking, frequent urination, or unusual bedwetting
we should do a BG test for each kid’s yearly physical.
I agree on these. Obviously, a broken arm would not require a BG test! So it would not be every time. But if a parent suspects flu? BG test! Unexpected weight loss? BG test! Same for the other symptoms you describe.
The cost is minimal! If they complain about the cost of strips, I’ll take up a collection and send them the damn strips.
What does it take to make this happen in the medical world? I mean, you know how doctors know soooo much more than us. What would it take for them to listen to some dumb bumpkins like us?
I think these two, along with lethargy are three of the MOST frequent symptoms of just about all diabetics (or pre-diabetics). These 3 (any, or all of them combined) should be reason to do BG stick at the office (even if we, the parents have to pay for it…I’d happily pay $5 for a test if it can have the potential of saving my sons life, or catching this disease early.)
Isn’t this all laid out in the insurance preventive care standards and such? What’s covered…what isn’t? I would think if we wanted to add this, we’d have to somehow touch the ACA because the healthcare standards are outlined in there and health insurances decide, based on that law, what types of care are covered and what aren’t. I would think, if nothing else, such a topic is one that we could write our legislators about as a concern that maybe they should address when updating health laws?
No idea if I’m right…it’s just my initial thoughts?
It’s because they’re generally checking their urine instead and aren’t generally alarmed until glucose starts spilling in urine… because blood glucose levels fluctuate so highly throughout the day… also home bg testers aren’t considered valid medical equipment that meet clinical standards so if they want to actually test blood glucose in a medically meaningful way they actually have to do IV blood draws and run labs… at least that’s my understanding
My moms a pediatrician who also writes for the journal “Clinical Pediatrics” (not sure if she still does actually) if we want to write out our questions on the subject I can ask her to type up a response.
It turns out you’re right. The AAP no longer recommends urine screening for well child checks. My moms response was that there was no excuse for diagnostic tests to have not been done when kids present with those symptoms… but that the AAP doesn’t recommend screening for non-obese and nonsymptomatic children at this time…
Pediatricians should be well aware… my mom has diagnosed dozens and dozens of T1 children… there’s really not a good excuse… and I’d also argue that there’s not a good excuse to be screening all children… as you point out it’s not like a glucometer strip is cost prohibitive
I am surprised it seems to be not more standard to know to look for in cases like these, it is unsettling…
I am not surprised that there are pediatricians and gp’s who routinely miss a specific set of symptoms, even ones that are painfully obvious to us.
I can’t tell you how many new patients I see who have periodontal and endodontic infections that have been “observed” for years by a previous dentist. TMJ dysfunction being missed is a daily occurrence.
I think this is the real issue; urine testing should be more common. I mean you can even buy some urine tests that detect glucose over the counter, so I’m confused as to why this isn’t more standard in a doctor’s office.
Per dr mom md; urine testing used to be standard for every pediatric visit (which certainly matches my recollection of childhood doctor visits) until relatively recently when the American Academy of Pediatrics removed it from the guidelines and standards of care for well-child visits… it should still be done whenever there are any unexplained symptoms…