My Type 1 Outpatient Support Team
A young man with diabetes describes how outpatient care made all the difference after a Type 1 diagnosis.
I was nervous when I was told I could go home from the hospital after my initial diagnosis of diabetic ketoacidosis. I had forgotten what life was like without a nurse checking my blood sugar levels every hour or a ham and cheese sandwich delivered at bedtime, just in case. All of those hospital elves I had come to rely on were about to disappear, and I wasn’t ready to deal with this diabetes thing on my own.
I was discharged after five days with the bare essentials: a blood glucose meter, a handful of diabetes supplies, some insulin dose instructions, a few photocopied fact sheets, and a referral to the diabetes outpatient clinic at my hospital.
Luckily, Australia has a government-funded health care system, and one of the benefits is comprehensive outpatient care for people with Type 1. I didn’t know when I left the hospital how valuable such services would be.
On my first visit to the outpatient clinic, I met my diabetes educator, Gwen. She said it was her job to teach me to think like a pancreas and make her role as my diabetes educator redundant. Gwen explained the role of the pancreas. We covered all of the basics, including carbohydrates, hypos, hypers, ketones, sick days, exercise, and travel. After two months, Gwen was confident that I didn’t need to see her anymore. She was, however, always available to me by phone or e-mail if I needed support.
I also had a few sessions with Krystina, my dietician. In these sessions we talked through my diet and found ways I could make improvements. I learned the value of slowly digested Low Glycemic Index foods, which form a big part of my diet today. I also learned about the effects of fiber and fat on my blood glucose levels.
I saw an endocrinologist every three months in the first year of my diagnosis. Unfortunately being a patient at a busy, government-funded clinic meant that I never received the attention I felt I needed. I never saw the same endocrinologist each time in the beginning. I struggled to be open and honest with a complete stranger, afraid I would be judged for imperfect numbers.
Thankfully, the care I received at the outpatient clinic more than made up for the shortcomings in my endocrinology care. Also, a government-funded health care system meant I could monitor for any possible side effects. If I needed my eyes, feet, or anything else checked, I was given a referral to another section of the hospital. I accessed 12 months worth of podiatry treatment on a stubborn foot wart in that first year alone.
Gwen told me that getting through my first year of diabetes would be the biggest hurdle to overcome. Luckily, I didn’t have to go it alone.
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