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Monday, May 20, 2013
When you have diabetes, it is important that you get good medical care and take care of yourself. Caring for diabetes is not an easy task sometimes. But you do not have to face it alone. Working with others can help make the job go a lot more smoothly. Key to good care is a health care team. Diabetes is complicated. Your doctor alone cannot be an expert in every area. For this reason, your diabetes care team may include different specialists depending upon what you need.
Your health care team should be available to help you manage your diabetes and maintain your good health, but the most important member of the team is YOU. Not only do you care for your diabetes every day, but you also play a lead role in the health care team. As a patient with diabetes, you have to make sure all information makes sense to you and that your health care team members are in good communication with one another. Some health care providers even offer Shared Medical Appointments or Group Appointments where other people with diabetes and multiple members of your health care team participate at the same time!
The American Diabetes Association provides useful information about your health care team. The following material is adapted from their website.
You are the most important member of your health care team. After all, you are the one who is affected by diabetes and cares for it every day. Only you know how you feel and what you're willing and able to do. You do the exercise. You make and eat the foods on your meal plan. You take the medicine or inject the insulin. You check your blood sugar (glucose) levels and keep track of the results. And of course, you are the first to notice any problems. Your health care team depends on you to talk to them honestly and to tell them how you feel.
The Primary Care Provider, who may be a primary care or family practice physician, is who you see for general checkups and when you get sick. A doctor with special training (and usually certification) in diseases such as diabetes is called an endocrinologist. If you do not see an endocrinologist, look for a primary doctor, family practice doctor or an internist who has cared for many people with diabetes. Your primary care doctor may also be the one who refers you to specialists or other team members.
Other health care providers who provide primary care include nurse practitioners and physician assistants, who typically work in collaboration with a physician.
A nurse educator or diabetes nurse practitioner is a registered nurse (RN) with special training and background in caring for and teaching people with diabetes. Many are certified in the field of diabetes (Certified Diabetes Educators or CDEs). Nurse educators often help you learn the day-to-day aspects of diabetes self-care. They can teach you
- What diabetes is
- How to cope with diabetes and to make changes in your health habits
- How to use diabetes medications
- How to work with insulin and give yourself shots
- How to check your blood sugar
- How to keep track of your diabetes
- Symptoms of low and high blood glucose
- How to take care of an insulin reaction
- How to handle sick days
- How to stay healthy if you are pregnant
A registered dietitian (RD) is trained in nutrition and can help you figure out your food needs based on your desired weight, lifestyle, medication, and other health goals (such as lowering blood fat levels or blood pressure).
This doctor is another key member of your health care team, because diabetes can affect the blood vessels in the eyes. When eye problems are caught early, there are very good treatments. The eye doctor will be either an ophthalmologist or an optometrist. The American Diabetes Association guidelines say you should see your eye doctor at least once a year. These checkups are the best way to detect diabetic eye disease. Your eye doctor will check for any changes in your eyes. If there are changes, the doctor will treat the problem or refer you to another doctor with special training in that area.
Mental health professionals help with the personal and emotional side of living with diabetes. There are different types of professionals. A social worker may be able to help you find resources to help with your medical or financial needs. Some social worker's may even be able to help you cope with many concerns related to diabetes, including problems within the family and coping with workplace situations. A clinical psychologist can provide counseling on a short term basis, for example help during a time of special stress, or on a long-term basis for more lasting problems. A psychiatrist can provide counseling and can also prescribe medication to treat physical causes for emotional problems. Marriage and family therapists can help you with personal problems in family and marital relationships and problems on the job.
This health professional is trained to treat feet and problems of the lower legs. Diabetes makes you prone to poor blood flow and nerve damage in the lower legs. You may get infections more often. Sores, even small ones, can quickly turn into serious problems. Any foot sore or callus needs to checked by your primary care doctor or a podiatrist. Do not try to fix these yourself, because you could cause an infection. But do inspect your feet daily for signs of trouble.
People with diabetes are at somewhat greater risk for gum disease. The excess blood sugar in your mouth makes it a good home for bacteria, which leads to infection.
This article is a NetWellness exclusive.
Last Reviewed: Jun 03, 2008
David C Aron, MD, MS
Professor of Medicine
School of Medicine
Case Western Reserve University