From Texas, USA:
I want to know which are the top five facilities are in the U.S. that specialize and treat diabetes in children and adolescents. Do you know if they prescribe insulin pumps?
The members of the Diabetes Team at Children with DIABETES are not in a position to list "the top five" programs. There are several criteria that you might find helpful to identify excellence:
- Is the educational program Recognized by the American Diabetes Association? ("Recognition" is a voluntary process that formally identifies diabetes patient education programs that meet the National Standards for Diabetes Patient Education as developed and tested under the auspices of the National Diabetes Advisory Board.) A list of Recognized Patient Education Programs is available at the ADA's website.
- Are the providers Recognized by the American Diabetes Association? The ADA has recently started a program called the Provider Recognition Program to rate the medical care given to people with diabetes (asking questions such as how many of their patients get glycohemoglobins regularly, or eye exams, or other items on a long list of standard diabetes care). The ADA has a list of such providers available.
- Do the members of the diabetes team have Certification as diabetes educators? The CDE initials indicate that the health care professional has met the standards of the National Certification Board for Diabetes Education as having the credentials to teach diabetes care.
- Is the program convenient (in terms of distance)? The best program in the world is no good, if you can't get there and back regularly: followup is critical in the care of kids (or adults!) with chronic medical disorders such as diabetes.
- Do the members of the diabetes team interact well with each other, and with kids and with the parents? Does the patient see the same team members on successive visits, or is the patient bounced around from one person to another? Do the health professionals seem to have time, or act "too busy"? These issues of "bedside manner" are very difficult to rate, and every person has the right to develop their own opinion after being in the program for a while. Sometimes the opinions of other physicians or other patients or parents might offer some clues on what to expect, but I've learned that such opinions vary - widely!
- Are the members of the diabetes team involved in local ADA and JDF activities? You can call the local offices of each organization, and find out who is involved with these volunteer organizations: are the health care professionals participating? Do they attend the meetings and charity events? Are they members of the local Board of Directors? Do they give educational presentations on behalf of the organization?
- Finally, be wary of ratings of "the best" programs based on the research that's done at that facility. Some facilities do lots of research, and yet the care of the patients is by relatively inexperienced trainee physicians with minimal supervision from the professors who are more interested in rat research than in people; other facilities do little or no research and are very focused on meeting the needs of their patients.
In answer to your second question: whether or not a program frequently advises use of insulin pumps would of course be a question you'd have to ask someone at the program: there's no national list of who does or does not use the devices.
Original posting 30 Sep 1998
Posted to Daily Care
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