Wellness: Today's Medicine
Working with Your Diabetes Health Care Team
If you have diabetes, you have plenty of company. The number of adults diagnosed with diabetes is increasing daily. You should also be keeping company with a number of health care providers, from your primary care doctor to your dentist, eye doctor, and foot doctor.
Diabetes affects the body in many complex ways, and having a team to help you stay as healthy and vital as possible, for as long as possible, is critical.
Yet no matter how much you depend on health care providers, you also have an important role as team leader. Developing a take-charge attitude can help you avoid some of the serious complications that can come with unmanaged diabetes.
No one but you can stay on top of:
Taking daily medications
Planning healthy meals
Controlling weight, blood sugar, blood pressure, and cholesterol
Getting regular exercise
Keeping appointments for regular dental care, eye exams, and foot care
Monitoring your glucose and other parameters as needed
Leading the team
The National Institute of Diabetes and Digestive and Kidney Diseases suggests that when choosing your health care providers, you select health care professionals who are familiar with diabetes, its effects, and its treatments. Ask how many of their patients have diabetes, and what kind of training and experience they have with diabetes care.
Think of these professionals as respected, knowledgeable people who are partners in your care. Don't expect them to second-guess all your needs, or even to remember all the details of your care. They depend on you to tell them honestly how you feel and what concerns you have.
Who should be on your team? It depends on your personal needs. Typically, patients with diabetes will see several, if not all, of the following health professionals.
Primary care physician (PCP)
This doctor coordinates all your health care needs, including your diabetes care. Because of the PCP's central role, take care in choosing someone who has treated many people with diabetes.
The PCP may be a family practice doctor, internist, or other general practitioner. (Some people with diabetes use an endocrinologist as a PCP. An endocrinologist is a doctor who has special training in diabetes and related illnesses.) Your PCP may occasionally refer you to an eye doctor, foot doctor, heart doctor, or other specialist. Each time you see one of these other health care providers, be sure the test results and other information are sent to your PCP, so he or she can stay up to date when coordinating your care.
Certified diabetes educator
This professional acts as a special partner to both you and your PCP, helping you put all your prescribed treatments into action. The certified diabetes educators (CDEs) may be nurses, doctors, dietitians, podiatrists, pharmacists, counselors, or exercise physiologists.
The CDE has special training in treating and caring for people with diabetes and will provide you with information about diabetes and teach you practical aspects of daily self-care. You'll receive instruction in everything from giving yourself insulin shots and checking your blood sugar to dealing with the symptoms of low blood sugar or insulin reactions.
Diabetes can affect the blood vessels in the eyes and lead to blindness. Unfortunately, once the symptoms are apparent, the damage is usually irreversible. For this reason, the American Diabetes Association recommends that people with diabetes see their ophthalmologist with expertise in the evaluation of diabetic retinopathy at least once a year for preventive care. Choose an eye doctor with experience in identifying and treating diabetic eye disease.
Uncontrolled diabetes may lead to poor blood flow, sores, and infections in the feet and lower legs. A podiatrist specializes in these areas of the body and can identify potential problems before they become more serious.
Because of the increased risks for gum disease and oral infections that come with diabetes, plan to see your dentist twice a year for regular visits. Be sure your dentist knows you have diabetes.
Registered dietitian (RD)
An RD works with you to determine an appropriate meal plan for you, based on your weight goals, the mediations you take, and other factors. Even if you have had diabetes for a while, consider talking with an RD. As you age, your nutritional needs can change. Look for an RD who has training in and experience with diabetes.
Social worker/psychologist/psychiatrist/marriage and family therapist
Managing a chronic illness involves many physical, emotional, and economic challenges — not just for the person with diabetes, but also for your family. These professionals can help you and your family learn how to cope with the emotional issues and stress of living with diabetes.