July 31, 2009

Guideline for Discussion

Many refer to first rule as a platitude, but for type 2 diabetes, it is a fact of life.

What works for me may not work for you. That is the first rule.
Always discuss things with your doctor(s). That is the second rule.
Always discuss changes with your doctor(s). That is the third rule.
The fourth rule is - all of the above!

I will advocate certain positions or ideas for those of us having type 2 diabetes. This is because I feel strongly about something, but you will have to decide if and how well it may apply to you.

If you are like me, you will glean ideas and apply what works for you and come back later to see if something may be applicable or explain something that is happening in your life. I do this with other blogs and sites.

I will not tell you that you must do this or that; you have a doctor(s) for that purpose. Your doctor(s) is the only person that can diagnose and prescribe proper treatment.

If what I write gives you ideas to discuss with your doctor(s), then I will be grateful. If you disagree with me and give me a sound reason, then I will have learned as well. I welcome constructive criticism, as I am human and make mistakes.

I advocate a team approach for the treatment of diabetes (the reason for doctor(s) above), with the patient in charge, except in emergencies. This has worked well for me. Members of the team should include a regular family doctor, a dietitian/nutritionist, and an endocrinologist. The following are optional depending on your needs - a neurologist, for neuropathy and sleep apnea, a podiatrist, for proper foot care and preventing amputations, a heart doctor, for heart disease, and an urologist, for monitoring kidney health. I almost forgot - an eye doctor for monitoring eye health and problems from diabetes (maybe not part of a team for some).

I know some people that have other doctors and specialists on their team for various medical problems. When it is possible, I also advocate making your pharmacist part of the team, but this is often more difficult for some. The biggest advantage to this is the communication and not prescribing conflicting medications and treatments. More doctors are working this way with knowledgeable patients who are willing to take charge. Even some insurance companies are finding out that there are less duplicate tests when one doctor orders the tests and shares with the rest.

Not everyone can have a team approach. This is because some people live in remote areas or in areas where the distance is great just to see a doctor. Other people find a doctor that is capable and has kept him or her-self up-to-date on diabetes and associated complications.

Diabetes is a 24/7 problem that requires a positive attitude and attention to detail for control. Most of us get derailed periodically. Sometimes we are able to determine the cause. Other times we never discover the cause, but are still able to regain control. The latter is the most frustrating and I am not immune to this.

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