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Robert Rapaport Part 5, Final Thoughts

In part 5, the conclusion of this Exclusive Interview, Dr. Robert Rapaport talks with Diabetes in Control Publisher Steve Freed during the AACE 2017 convention in Austin, Texas about what he wants healthcare practitioners to understand about transitioning pediatric patients and his goals for his patients’ A1C.

Robert Rapaport, MD is Professor of Pediatrics, Chief of the Division of Pediatric Endocrinology and Diabetes and the Emma Elizabeth Sullivan Professor of Pediatric Endocrinology and Diabetes at Icahn School of Medicine at Mount Sinai, New York.

Transcript of this video segment:

Steve:  Assuming that your audience are family practitioners that deal with diabetes, not so much endocrinologists, what would you like to say to them as far as getting a new type 1 patient being transitioned from pediatrician [to adult practice]?

Dr. Rapaport:  For accuracy, the topic was type 2 in transition, but any child with diabetes who becomes of a certain age as an emerging adult needs to be transitioned to an adult healthcare team.  So, what we need to encourage is the collaboration and intermingling of the two camps to have transfer of information, to have open-ended discussions with the patient and the family, to have the family and the patient know the expectations, especially the young adult, have expectations that this will be slightly different that you’re used to in the pediatric practice, and what the expectations are. Transfer of records is crucial.  We want to make sure that whoever will take on the care of this individual is aware of all the previous health issues that the person has.

Steve:  I know each person is an individual and it is different.  But, on average where would you like to see your patients A1C in the pediatrics without hypoglycemia?

Dr. Rapaport:  It is an interesting question.  We want to see HbA1c as close to normal as possible while avoiding hypoglycemia.  As you know there are studies coming out that are saying that A1c is not probably the sole arbiter of good control.  We need to start now looking at fluctuations at blood glucose levels, highs and lows, the A1c is just an average thereof.

Steve:  I want to thank you for your time.  Enjoy the rest of your stay here.

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