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    • 6 minutes ago
      atr likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      When I test positive, I increase my insulin dosage to a “sick day” level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out. Also, increase my water intake. I would not call my Endo unless I was unable to get my blood glucose down over a lengthy period of time. That has never been the case.
    • 9 minutes ago
      atr likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I had ketones thrn I am sick. If mid to large I wd call my endo or if also vomiting or dehydrated from diarrhea. I wd go to the ER
    • 1 hour, 23 minutes ago
      Marty likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I were not feeling too bad, I would change my site, increase my insulin, drink more water and monitor closely
    • 1 hour, 24 minutes ago
      Marty likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      When I test positive, I increase my insulin dosage to a “sick day” level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out. Also, increase my water intake. I would not call my Endo unless I was unable to get my blood glucose down over a lengthy period of time. That has never been the case.
    • 1 hour, 31 minutes ago
      KSannie likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      None of the specialists I’ve seen have suggested, recommended or prescribed methods for doing this in the lovely 40 years I’ve been T1D. My 80th birthday is the summer. It will officially be half of my life.
    • 1 hour, 33 minutes ago
      Patricia Dalrymple likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      I'd most likely call my endocrinologist and ask their advice.
    • 1 hour, 47 minutes ago
      Lawrence S. likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      I increase my basal and insulin ratios if I eat until I show no longer test positive. I do only test if I have been high for a longer than usual time.
    • 1 hour, 47 minutes ago
      Lawrence S. likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I were not feeling too bad, I would change my site, increase my insulin, drink more water and monitor closely
    • 2 hours, 9 minutes ago
      Judith Halterman likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      I'd most likely call my endocrinologist and ask their advice.
    • 2 hours, 12 minutes ago
      Derek West likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I were not feeling too bad, I would change my site, increase my insulin, drink more water and monitor closely
    • 17 hours, 21 minutes ago
      KCR likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      None of the specialists I’ve seen have suggested, recommended or prescribed methods for doing this in the lovely 40 years I’ve been T1D. My 80th birthday is the summer. It will officially be half of my life.
    • 23 hours, 54 minutes ago
      Marty likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I have a blood ketone monitor. It works just like a glucometer.
    • 1 day, 1 hour ago
      Kathy Hanavan likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      Perhaps only the poets who love alliteration could love the phrase, “killer ketones.” The ungodly pain experienced is your body eating and devouring itself. 🥵 Ketones are relentless killers. Do not give the bad guys a chance.
    • 1 day, 2 hours ago
      Judith Halterman likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      Perhaps only the poets who love alliteration could love the phrase, “killer ketones.” The ungodly pain experienced is your body eating and devouring itself. 🥵 Ketones are relentless killers. Do not give the bad guys a chance.
    • 1 day, 20 hours ago
      Anthony Harder likes your comment at
      Do you have ketone testing strips?
      Hi, Marty. Does your specialist have a source for that claim? It makes little sense that ketones would rise faster than BG since the metabolic pathway is much slower. If there's a source, however, I'd look further into the claim. FWIW, I've been a Type 1 for over 50 years; I can't remember the last time I tested for ketones. I possess no ketone testing strips.
    • 2 days, 23 hours ago
      Marty likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      Covers it with co pay
    • 3 days ago
      atr likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      It covers both. I prefer to have the the nasal version as I think it would be easier for someone else to administer.
    • 3 days, 2 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      I’ve been T1D for 60 years. As a child my mother didn’t like needles or injections so she just fed me when low. In college, explained use to dorm mates and classmates would’ve been a waste of time. Now married, my wife assumed the role of my mother and doesn’t like using needles on me either. I don’t have glucagon.
    • 3 days, 2 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      Yes, always have one or two nasal glucagon kits (Baqsimi) at home in easy to reach locations (ie at bedside and special container in living area) and always keep one with me when I go out ( along with glucose tabs or other simple carbs for treating LBS.). I apparently required injectable glucagon several times as a child and needed injectable glucagon only twice as an adult, both more than 15 years ago . More recently I needed my husband to give me Baqsimi after eating a difficult to dose for, high fat meal. The experience was terrifying so I don’t go anywhere without it now.
    • 3 days, 2 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      I actually have 2 non-expired prescriptions. One for Baqsimi and one for Gvoke. I have not filled either of them because they’re $500-600 each.
    • 3 days, 2 hours ago
      Lawrence S. likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      My Medicare Part D essentially doesn't cover glucagon when any form is nearly $500!
    • 3 days, 17 hours ago
      Amanda Barras likes your comment at
      Do you have a non-expired glucagon prescription?
      Same here. Been as low as 19 (struggling with a vacuum cleaner bag and refused to let it win) but was still able to swallow food. I did used the “red needle” as my husband refers to it once when I went low but was scheduled for surgery and couldn’t eat or drink anything. Only once in 26 years. Fortunate.
    • 4 days, 11 hours ago
      Karen Newe likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 5 days ago
      Natalie Daley likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 5 days, 1 hour ago
      atr likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
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    How would you go about finding a new T1D healthcare provider if you moved to a new location? Select all that apply.

    Home > LC Polls > How would you go about finding a new T1D healthcare provider if you moved to a new location? Select all that apply.
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    If you use an insulin pump, when a pump site does not last the full amount of time it is supposed to last, do you contact customer service for replacement supplies?

    Sarah Howard

    Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.

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    " At T1D Exchange, we’re proud to announce our Medical and Research Advisory Team — an accomplished group of leaders in endocrinology, research, and quality improvement. Together, they are redefining what’s possible in type 1 diabetes (T1D) care through rigorous data analysis, innovative research approaches, and real-world implementation. Their collective expertise is central to our mission of improving outcomes for all people living with T1D.  “We’re excited to be working with our advisors given their deep expertise across a broad range of areas in T1D,” said Dave Walton, CEO of T1D Exchange. “Their involvement magnifies our reach, knowledge, and impact. These advisors are shaping the future of diabetes care — driving innovation across research, clinical practice, and quality improvement.”    Meet the Medical & Research Advisory Team  The T1D Exchange Medical and Research Advisory Team brings together four leading endocrinologists, each offering a unique perspective and shared commitment to advancing T1D care:    Jenise Wong, MD, PhD Pediatric endocrinologist at UCSF Benioff Children’s Hospital and Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco Focus areas: Diabetes technology adoption and usability; health equity and access to care and technology; community-based and peer-support interventions; culturally responsive care          Jennifer Sherr, MD, PhD Pediatric endocrinologist at Yale Medicine and Professor of Pediatrics in the Division of Endocrinology at Yale School of Medicine in New Haven, Connecticut Focus areas: Clinical trials in diabetes technology (CGM and AID systems), disease-modifying treatments and immunotherapies, and emerging technologies and medications, including continuous ketone monitoring and nasal glucagon     Viral Shah, MD Adult endocrinologist at Indiana University Health and Professor of Medicine in the Division of Endocrinology and Metabolism at Indiana University School of Medicine in Indianapolis, Indiana Focus areas: Diabetes technology and adjunctive therapy trials; translational and data-driven research; T1D complications and bone health         Nestoras Mathioudakis, MD, MHS Adult endocrinologist at Johns Hopkins Medicine and Associate Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland Focus areas: AI-driven clinical support tools; EMR-based data analytics for clinical decision making; data-driven quality improvement; health equity in T1D care        This accomplished team’s expertise spans adult and pediatric endocrinology, research, and quality improvement affiliated with leading institutions nationwide. Collectively, they have authored over 500 diabetes publications and secured research funding from organizations such as the National Institutes of Health, Helmsley Charitable Trust, the American Diabetes Association, and Breakthrough T1D — while remaining actively engaged in both clinical care and research.  “These individuals represent an impressive body of work while remaining deeply involved in the day-to-day realities of diabetes care,” said Walton. Their expertise covers the full spectrum of T1D care — from AI and predictive analytics to complication prevention, automated insulin delivery, continuous glucose and ketone monitoring, GLP-1 treatments, health equity, mental health, autoantibody screening, and disease prevention.    Turning insight into impact  The team’s work goes beyond research, focusing on translating insights into real-world practice. By leveraging data to scale best practices, the goal is to drive meaningful, measurable change across clinics and communities.  “Our advisors will help to extend our impact — whether through QI strategy, research innovation, funding opportunities, or new data-driven solutions,” said Walton. “We want to take what’s working at individual centers and spread that as broadly as possible.”   He added, “As a Collaborative, we’re also focused on advanced population health strategies such as exploring predictive data models to identify risks earlier and intervene before complications even begin to happen.”    The power of the T1D Exchange Quality Improvement Collaborative  Central to this work is the T1D Exchange Quality Improvement Collaborative (T1DX-QI) — a nationwide network of clinics working together to improve care through shared data, benchmarking, and evidence-based practices.  “I’m thrilled to serve as a Medical Advisor for T1D Exchange, because I’ve seen firsthand the impact this network can have on patient care,” said Dr. Nestoras Mathioudakis. “T1D Exchange is the premier organization for quality improvement in type 1 diabetes, with unparalleled assets like a large EHR database and robust patient registry.”  He added that he is excited to apply his expertise in EHR research and big data analytics to generate real-world evidence across diagnosis, management, and outcomes.  Dr. Viral Shah echoed that perspective, reflecting on T1DX-QI's evolution: “I have been involved with T1D Exchange since its early days and have had the privilege of witnessing how it has transformed the quality of diabetes care across the United States. I’m delighted to return as a Medical Advisor.”  He emphasized the importance of accelerating impact. “I look forward to working closely with the team to accelerate the evidence generation and to help translate these insights to improve patient care.”   Dr. Jenise Wong highlighted the visible impact of T1DX-QI on the delivery of care. "I’m truly honored and grateful to be working with T1D Exchange as a Medical Advisor. T1DX-QI is a remarkable resource for centers that are using continuous process improvement to improve the quality of care for people living with diabetes.”  “Diabetes centers working with T1DX –QI have done amazing work using QI methodology to make care accessible and equitable for all people with diabetes,” she said. “It’s inspiring to be a part of a collaborative in which centers have been creative and thoughtful with initiatives to address individual and systemic challenges to care, improving clinical outcomes as well as the patient experience."  Looking ahead, Dr. Sherr highlighted the opportunity to build on the existing strong foundation. “I’m very excited to be working as a Medical Advisor for T1D Exchange,” she said. “It’s a privilege to help shape what comes next for a group that’s already doing such impactful work.”  “Sharing what’s happening in clinical practice, benchmarking across centers, and understanding outcomes is how we figure out what’s working, what’s not, and where we go next,” she said.      The future of T1D care   With this team’s vision and expertise, T1D Exchange is positioned to accelerate progress in T1D care — bridging research and real-world practice to drive meaningful, measurable impact.  Together, we look forward to advancing innovation and improving outcomes for everyone affected by type 1 diabetes.   "

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    33 Comments

    1. Steven Gill

      Since my diagnosis 24 years ago I’ve seen 5 different endocrinologists. The first said I was too old to be a TYPE 1 and my ideal weight was…….. The second was at those medical trials, very informative and detailed (at first sight said I was 20-25 lbs underweight and a Type 1: later supported by labwork). Thanks to changing jobs/insurance saw several others, the last got me pumping but otherwise I’m not enthralled that because one is an endocrinologist (specialized in hormones) necessarily mean one is skilled in diabetic care.

      My first doc was a general practitioner, while admitted a lack of experience we looked at my glucose readings and diet together and after 3 weeks on insulin moved me to meds than diet alone (I was the perfect TYPE 2: obese, ate and drank everything literally). He suggested carb counting, higher fiber diet, and of course if I wanted my feet cut off I could keep my 5-6 weekly cases of beer. Unfortunately he decided to die on me.

      I moved 17 months ago, asked neighbors about local physicians. I see an older general practitioner who sends all his TYPE 1 and “poorly controlled” TYPE 2 diabetics to the local hospital/diabetic clinic. He’s never seen an insulin pump nor a CGM, but with all my a1C numbers, my control agreed if I was comfortable he’d follow my diabetic care. And when time for renewal sent the prescription for the new system, goes over all my lab work with a ton of questions.

      So…. asking neighbors, kind of interviewing the doctor. The fun stuffs coming up, gonna ask for specific tests, trusting he’ll be open minded and agreeable. But than again the doc at those trials said I was the one controlling my diabetes, the doctor only sees lab work and hears my lies. They don’t cook for me, work with me, exercise for me, nor test my levels constantly. No doctor dictate my insulin usage, that changes too much to live a good life to wait for a quarterly annual visit. Must work for me, a1C is now 6.0 and having a ball! I’ll be surprised if not lower in 2 weeks.

      2
      3 years ago Log in to Reply
    2. Nicholas Argento

      If you use diabetes technology, one way to find someone who believes in it and uses it is to ask for the representative of your technology such as Dexcom, Medtronic or Tandem, and get the name of the that local rep, contact them and see if they can give you name of the person who for that company covers the zip code you are moving to. They will know who prescribes and who doesn’t. They know their area. If you are using diabetes technology and want a tech savvy provider, this is one way to do it.

      8
      3 years ago Log in to Reply
      1. cynthia jaworski

        Great idea. I have never seen it suggested. Thanks.

        1
        3 years ago Log in to Reply
      2. Drina Nicole Jewell

        This is brilliant!

        1
        3 years ago Log in to Reply
    3. RegMunro

      Over the past 57 years I have changed my key advisor fairly often. My first was a general practitioner who actually didn’t know much about T1D. So I moved to a specialist. Since then I’ve tended to change when the consultation became too repetitive around the simple facts or around his special interest, one was very keen on inhaled insulin. I’m currently considering a change after the longest period with one specialists as I suspect I may need help dealing with T1D related, but not specific symptoms. For example, I’ve tried cardiac, neuro and psychological specialists exploring possible causes of actually fairly minor but possibly significant issues that are probably common to most octogenarians

      3 years ago Log in to Reply
    4. LizB

      I called the large hospital near my apartment (most will have a “find a doctor” search on their site) and told them I had Type 1 diabetes and needed an endo, and made an appointment. I ended up with a fantastic endo and saw her for 15 years. Last year my insurance decided that hospital was out of network so I had to find a new one. Called another large teaching hospital nearby and told them I had Type 1 and needed an endo. As I was talking to the person I was also scrolling through the website because some that she was recommending were not diabetes specialists. I ended up with my current endo who I also like.

      3 years ago Log in to Reply
    5. Mary Ann Sayers

      When I moved from Springfield to Boston,Ma I contacted Joslin Clinic to make an appointment. That was in 1996 and have continued having Joslin physicians overseeing my T1D since then.

      1
      3 years ago Log in to Reply
      1. Lawrence S.

        I went to Joslin in Syracuse, after spending a week in the educational component of Deaconess Hospital and Joslin in Boston. I loved the Syracuse Joslin Clinic.

        3 years ago Log in to Reply
    6. Marthaeg

      Anyone have a recommendation for an endocrinologist (Whole food, plant based believer) in the Dallas area?

      3 years ago Log in to Reply
    7. Gary Taylor

      I just move to my new community 6 months ago. I started asking around and doing internet research, especially hospital/clinic systems in the area. There are NO endocrinologists in the area and only ONE nurse practitioner who specializes in endocrinology. The NP is booked out at least 6 to 8 months. In July, I made an appointment for this January and asked to be put on a wait list for an opening. I was fortunate to get an opening in early October. For the first visit, she was wonderful. Now I will have to get to know her better.

      3 years ago Log in to Reply
    8. Jane Cerullo

      With Medicare advantage you need to research in network physicians. Then you can research each provider individually.

      2
      3 years ago Log in to Reply
    9. Janice Bohn

      I would take advantage of all resources- insurance coverage for providers would be 1st step. Then vetting through reviews and other sources such as area JDRF etc.

      2
      3 years ago Log in to Reply
    10. Lawrence S.

      First, I check to see which Endocrinologists are covered by my health insurance. Then I checked internet sites for doctor ratings. In my current case, I ended up going to a nearby hospital Endo office because all of my medical services are covered by this hospital. Since I started with them, ten years ago, I’ve had four different providers, two doctors and two APRN’s.
      I do miss Joslin.

      3 years ago Log in to Reply
    11. AnitaS

      First I look at endos who are covered by my insurance. I then look at endos who are in my general area. I could then if I wanted to ask on diabetes websites for anyone to recommend a provider who met met my first two criteria.

      2
      3 years ago Log in to Reply
    12. Drina Nicole Jewell

      I’ve called clinics my insurance works with and ask questions about the endo’s there to help find one that’ll work with me and my type 1 management style.

      3 years ago Log in to Reply
    13. Eva

      First, I would ask my current endo for a recommendation.
      Second, I would ask the insurance company for recommendations.
      Third, I would ask diabetes community for recommendations
      And I would also want to interview all of the endo’s. I would want to know how they treat patients like me. Their philosophy is the use of medicine rather than make lifestyle changes, like diet and exercise. How are patient’s vitamin and minerals measured ( i was low in vitamin b1 and b12)?
      Do they conduct in research, in what areas?

      1
      3 years ago Log in to Reply
    14. James Hoare

      I will not be moving again thank heaven.

      1
      3 years ago Log in to Reply
    15. Mike Plante

      I would first look to see if there was a nearby provider listed on this website to ensure I find a provider that accepts patients using DIY Loop: https://www.loopandlearn.org/hcp-recommendations/

      If I didn’t find a suitable provider at the above site, I would try looking at this list: http://juiceboxdocs.com

      1
      3 years ago Log in to Reply
      1. TomH

        Makes two of us. I recommend Loop and Learn as well!

        3 years ago Log in to Reply
    16. Kathleen Juzenas

      Besides asking my current endocrinologist, I would ask my primary care physician for recommendations. Then I would do further research on my own.

      2
      3 years ago Log in to Reply
    17. Sue Martin

      When I moved to the Seattle area, my father who was a doctor, recommended I go to the University of Washington Diabetes Care Center. One of the top national Endos is still at that clinic. My dad suggested I try to get to be that doctor’s patient. I ended up with another Endo, who I saw for about 20 years until she retired. She passed me on to another doctor in that clinic. I really like the University of Washington Medical Center and all its aspects and clinics. They are a teaching and research hospital system so they often have the latest medical information. They also pass on the information and savings on medications to the patients. I’ve had to use several specialty clinics, neurosurgery, transplant care, and ophthalmology. I would recommend them to anyone in the Puget Sound Region.
      If I was to move to another area or state, I would look for a medical system like the UWMC.

      1
      3 years ago Log in to Reply
    18. Derek West

      When I moved I tried to search out a teaching hospital with endocrinologists. They were usually attached to a University.

      1
      3 years ago Log in to Reply
    19. TomH

      My experience with referrals has been terrible. Ones from my PCP resulted in Dr’s that had been retired for 1-5 years, no longer in the area, not accepting new patients…let alone in network. I’d much more rely on word of mouth from other T1s or sources like the Loop and Learn group website that has established a patient referral list of good Endo’s/Docs/NPs based on first hand knowledge!

      2
      3 years ago Log in to Reply
    20. Jeff Perzan

      I always choose an endocrinologist associated with an academic medical institution.

      1
      3 years ago Log in to Reply
    21. Stuart Pelcyger

      While I think all the comments are great. There is one thing that no one has mentioned—the ability for you to be the captain of your medical team. There could be a host of other medical professionals involved in your care and you have to be the one to set the tone with guidance and advice from all these different sources. And be able to question them and advocate for your own life choices. A long time ago, I saw an endo who wanted to dictate everything around his plan for managing my disease. While he had impeccable creds and was thought very highly by others, I couldn’t accede to his demands. I was working a 4-midnight shift and he wanted me to eat at 6 pm every night. When I told him I would try but make no guarantees he told me that was the only way he could manage my disease. I told him, I am managing my disease and you are an advisor. I then went elsewhere.

      1
      3 years ago Log in to Reply
      1. sweet charlie

        My first 20 years T1D I never saw a “specialist”.. Then I moved across country and asked at the local Hospital and they gave one local Endo name to me… like the guy you described… The next 50 years I have been my specialist!!! I do not have any so called T1D problems..

        3 years ago Log in to Reply
    22. Becky Hertz

      I chose all of the above. I’d be willing to travel farther for a really good provider though. Thankfully, I’ve always lived in larger population areas.

      3 years ago Log in to Reply
    23. M C

      I am with my current Endo because of the word of other T1D’s who told me about the office and great group of doctors – Had my GP make the referral, and have been with this doctor/group for over 10 years now.

      3 years ago Log in to Reply
    24. George Lovelace

      I would use the World Wide Listings at http://www.insulin-pumpers.org/pumpdocs.cgi

      3 years ago Log in to Reply
    25. Joan McGinnis

      I am not moving for sure. But i would network everything in my power before choosing a new endo. in town or out so I know everything I can about my options. I
      am not shy and would go out of my way to find online or in person ways to meet others with T1D.

      3 years ago Log in to Reply
    26. Carrolyn Barloco

      We are retired Air Force and I have gone to the Diabetes Center of Excellence at Wilford Hall for 23 years.

      3 years ago Log in to Reply
    27. T1D4LongTime

      Referral, Call or search through my health insurance provider, choose whichever endo clinic is easily accessible. I also would check credentials and specialities of endocrinologists in the area.

      3 years ago Log in to Reply
    28. PamK

      I would also check with my local JDRF/ADA for recommendations!

      3 years ago Log in to Reply

    How would you go about finding a new T1D healthcare provider if you moved to a new location? Select all that apply. Cancel reply

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