Finding The Right Endocrinologist
Finding a doctor who meets your specific needs is important.
If available, a person diagnosed with BT1D should seek a Board Certified endocrinologist who specializes in diabetes and diabetic complications. If unavailable, look for a Diabetologist, a physician, Board certified in a different discipline ( like cardiology) with a sub-specialty in diabetes.
Ideally, a doctor treating a brittle diabetic should:
1. LISTEN to what their patients are saying. “I’m doing everything right but it still comes out wrong”. The key to diagnosis and treatment begins with a medical history and a better understanding of the person . It is important that the Brittle Diabetic be honest with the physician if they are experiencing emotional stress or depression because it can negatively impact BG levels.
2. BE A DETECTIVE and customize a treatment program aimed at doing more than just attempting to stabilize BG levels. There is general agreement that there is an underlying cause for brittleness . In some instances a single cause may be the culprit such as celiac disease or gastroparesis, but many times it’s a multitude or combination of factors that serve to generate this abnormal shift in BG levels. Psychosocial issues must also be considered. 50% of brittle diabetics revert to a stable Type 1 condition following treatment of the underlying cause.
3. RUN TESTS geared to the elimination of known causes of brittleness which necessitates that he see you regularly. If he says, you’re brittle and I’ll see you in six months without scheduling tests ask why the delay.
4. BE ENCOURAGING. All too often you hear, “you’ll never be able to do that again”. Just look how many gold medal Olympians and 5 star celebrities have type1 diabetes and are pursuing their dreams.
5. BE WILLING TO MODIFY his game plan or treatment direction depending on your life activities.
6. ARRANGE for knowledgeable diabetes educators, nutritionists but most of all technologists knowledgeable about the latest equipment advances available to help better control BG levels.
7. BE WILLING to entertain and discuss new concepts. In the diabecon lecture videos of 2010 a mathematical measurement for glycemic instability called MODD (Mean of Daily Difference) is offered as a possible way to distinguish brittle diabetes from stable type 1 diabetes.
There is an estimated 27.5 million Type 2 and some 1.5 million type 1 diabetics in the USA of which 2.9/1000 Type 1’s are found to have uncontrollable shifting of BG from extremely high to low and in reverse for no apparent reason. There are some 4,500 people in the United States with BT1D. BDF would hope that an individual diagnosed as "Brittle" does not get lost in a medical practice that treats them like a stable Type1 .