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FAQs

Have a question about our services? See our frequently asked questions below. For further information or to make an appointment, please call our Novi, Michigan office at (248) 347-3344 or you can use our secure online appointment request form.

General FAQs

What do we bring to our appointment?

  • The name and phone number of your referring provider
  • The name and phone number of your pharmacy
  • A referral form if required by your insurance company
  • Your insurance card(s) and your driver's license
  • Your child's medical records, including growth charts, if not already provided by your child's referring doctor's office. To improve the quality of time spent during your visit, we advise you to call ahead to ensure that we have received all necessary records.
  • If a bone age study has been done, please bring a copy of the actual film, not just the report. This can be obtained only from the radiology department where the X-ray was performed.

How long will our first consultation last?

Forty minutes are blocked off for most new patient appointments though some are scheduled for one hour. Please let our receptionist know the nature of your visit so that we can block off the appropriate amount of time for you and your child. 

To remain as prompt as possible, we ask that you arrive 15 minutes prior to your scheduled appointment time to complete the registration. Please call if you'll be unusually delayed.

What should I expect from the first visit?

Once you complete all the necessary forms and we verify your insurance information, our medical assistant will guide you to one of our exam rooms. She will check your child’s vital signs and obtain a height and weight measurement. Dr. Bishop will then obtain a history and perform an exam.

If there is a question about pubertal development, a short and painless puberty exam will be performed. If this is something that may make your child uncomfortable, please discuss this with him or her prior to the appointment.

Dr. Bishop will then review with you any lab work or imaging tests that have been done. Please do not hesitate to ask questions about your child's health. Depending on her evaluation, Dr. Bishop may order additional tests.

Often, a follow-up visit is scheduled to discuss any test results. A complete report of Dr. Bishop's assessment and plan will be sent to your doctor on the day of your appointment.

Can I reschedule our appointment?

For the convenience of our patients, we ask that you give us a 24-hour notice of your cancellation. We generally can reschedule your appointment within a week or two. Appointments not cancelled within a 24-hour period will be subject to a $50 cancellation fee.

Diabetes FAQs

What do we bring to our first appointment?

  • The name and phone number of your referring provider
  • The name and phone number of your pharmacy
  • A referral form, if required by your insurance company
  • Your insurance card(s) and your driver's license
  • Your child's medical records, including previous lab tests, if not already sent by your child's primary healthcare provider. To improve the quality of time spent during your visit, we advise you to call ahead to ensure that we have received all necessary records.
  • Your glucometer as well as any other diabetes supplies/snacks you may need to last the 2-3 hours of the first appointment.
  • And, most importantly, blood sugar readings from at least the last two weeks. Please make sure the time and date are accurate on the meter as well as on the blood sugar record sheets prior to your visit.

What should I expect from the first visit?

Once you have completed all the necessary forms and we have verified your insurance information, our medical assistant will guide you to our diabetes teaching room. She will obtain a height and weight measurement and check your child’s vital signs, blood glucose, and A1C.

Our diabetes educator will spend the first 1-2 hours with you. This visit is intended to assess your diabetes management and to introduce you to how we manage diabetes in our practice. There are so many right ways to manage diabetes. We want to make sure we are all on the same page.

She will discuss your history and diabetes management with Dr. Bishop. Dr. Bishop will then meet with you to obtain any further history that is needed and to perform an exam. She will review blood sugar patterns with you and will make any insulin dose adjustments that are necessary.

Dr. Bishop will then review any lab work that has been done and assess the need for any further testing. Please do not hesitate to ask questions about your child’s health. Depending on her evaluation, Dr. Bishop may order additional tests.

A complete report of Dr. Bishop’s assessment and plan will be sent to your doctor on the day of your appointment.

Will follow-up visits last as long as the first appointment?

No, in fact they are much shorter. Follow-up diabetes appointments are typically 30 minutes long. You will only be meeting with Dr. Bishop at these appointments. If you would like to meet with our diabetes educator, you are always welcome to schedule an appointment with her separately.

Dr. Bishop’s primary goal at each appointment is to determine insulin dose needs. For the safety and health of the patient, it is crucial that you provide complete and accurate blood sugar readings at each appointment. Two weeks of blood sugar readings are sufficient. 

We will download data from insulin pumps and continuous glucose monitors (CGMs), however, we do not download readings off of meters. You may bring in downloaded readings instead.

How long will the consultation last?

We recommend that you reserve 2-3 hours for your initial visit with us. The first 1-2 hours is blocked off with our diabetes educator. Another hour is scheduled with Dr. Bishop.

To remain as prompt as possible, we ask that you arrive 15 minutes prior to your scheduled appointment time to complete the registration, or you can complete the registration form online. Please call if you'll be unusually delayed.

How often do we need to see Dr. Bishop?

Diabetes follow-up visits are scheduled for every three months. However if diabetes control is worsening, Dr. Bishop will likely ask to see you more often.

Can I reschedule our appointment?

For the convenience of our patients, we ask that you give us 24 hours’ notice of your cancellation. We generally can reschedule your appointment within a week or two. Appointments not cancelled within 24 hours are subject to a $50 cancellation fee.

Do you check A1C in the office or do I have to take my child to the lab?

We do A1C tests in the office at each 3-month visit and bill it to your insurance.

Do you offer insulin pump and CGM training in your office?

Yes, our CDE does all pump and CGM training in the office. Training typically involves several visits.

Many over-the-counter medications (i.e., cold medicines, wart removers, etc.) say to call a doctor when using in a person with diabetes. Are these medications OK?

Yes, the amount of carbohydrates in the oral preparations is minimal and therefore we have no concerns regarding their use. Topical medications are fine, too, unless your child has known circulation problems, which is rare in children with type 1 diabetes.

Do I really need to get rid of my insulin after 30 days?

Yes. Studies show that the insulin is not as effective after this time period.

What do I do if I accidentally missed or mixed up my insulins?

This typically happens to everyone at least once. Mistakes happen! Call Dr. Bishop for advice.

My child has had several low blood sugars in a row. What do I do?

If after 2-3 low blood sugar treatments your child's blood sugar is still low, please call Dr. Bishop.

My child has been waking frequently with abdominal pain and/or headaches. Should I be concerned?

Morning abdominal pain or headaches can be a reflection of overnight low blood sugars. If these symptoms are occurring, make sure to check some 2 am blood sugars for a few nights to rule out overnight hypoglycemia.

Is there a blood sugar value that should prompt me to seek medical attention for my child?

Blood sugar levels are just pieces of information that allow you to appropriately dose the insulin and to assess its effectiveness. There is no one number above which you should panic.

If the blood sugar is abnormally high, think about whether your child received the appropriate insulin dose earlier in the day or whether he or she ate more carbohydrates than you thought or planned on. There is no need to give extra insulin at those times unless your child has moderate or large ketones.

If there is a 3-4 day pattern of elevated blood sugars at the same time of day, feel free to call Dr. Bishop during office hours or email her to receive help with insulin adjustments. She will make every effort to get back to you by the end of the day.

My diabetic child doesn't feel well. What do we do?

Make sure to check urine ketones whenever your child doesn't feel well. Continue checking blood sugars just as you normally would (before meals and at bedtime). Blood sugars will typically be elevated when your child doesn't feel well, but as long as his or her ketones are negative or trace, we don't recommend adding any extra insulin.

If ketones are present, refer to the sick day management section of your diabetes notebook for appropriate management. Download our Sick Day Guidelines. Call Dr. Bishop if you have any concerns.

My diabetic child feels ill and isn't very hungry. What do we do differently?

The most important thing is to make sure to continue insulin doses even if he or she doesn't feel hungry. Without it, your child can quickly develop ketoacidosis.

If your child is on Lantus, the full dose should be given. Other insulin doses will likely need to be decreased if your child is not eating as many carbohydrates as usual. If you're unsure of how much to give, call us and we'll be able to assist you.

Make sure to keep your child well hydrated with water. Continue checking ketones every time he or she urinates. If ketones are present, refer to the sick day management section of your diabetes notebook for appropriate management. Download our Sick Day Guidelines. Call Dr. Bishop if you have any concerns.

My diabetic child is vomiting. What do I do?

Try giving very small amounts of fluid infrequently (starting with just a teaspoon of clear carbohydrate-containing fluids). Wait 10 minutes and give slightly more fluid. Continue this process very gradually. Large amounts of fluid will often lead to nausea. If your child can’t tolerate even these small amounts of fluid, call us.

Follow blood sugars closely. Call us with any concerns. Continue checking ketones every time your child urinates. If ketones are present, refer to the sick day management section of your diabetes notebook for appropriate management. Download our Sick Day Guidelines form. Call Dr. Bishop if you have any concerns.

My diabetic child has moderate to large ketones. What do I do?

When ketones are present in greater than trace amounts, extra fast-acting insulin (i.e. Humalog, Novolog, or Apidra) is needed. The extra insulin should be added to the next scheduled dose of insulin. If ketones are present, refer to the sick day management section of your diabetes notebook for appropriate management. Download our Sick Day Guidelines. Call Dr. Bishop if you have any concerns.

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