Who Is On Your Diabetes Care Team? - Part 2

A Podiatrist: This health professional is trained to treat feet and problems of the lower legs. For anyone with diabetes, which can cause nerve damage in the extremities, foot care is important. Podiatrists have a Doctor of Podiatric Medicine (DPM) degree from a college of podiatry. They have also done a residency (hospital training) in podiatry. This doctor is important for care of your feet and lower legs and to help you prevent problems with foot ulcers and other cuts or bruises that don't heal as fast as they should.

The last two individuals are often optional and sometimes not available in largely rural areas. If you are taking insulin then this doctor could be important if available:

An Endocrinologist: An endocrinologist should also be seen regularly. An endocrinologist is a doctor who has special training and experience in treating people with diabetes and is important for people on insulin.

Exercise trainer:  This person is totally optional and unless you can afford this person, ignore this specialist:   Exercise plays a major role in your diabetes care, no matter what kind of diabetes you have. The best person to plan your fitness program -- along with your doctor -- is someone trained in the scientific basis of exercise and in safe conditioning methods.

People with diabetes who are treated with insulin shots generally should see their doctor at least every three to four months. Those who are treated with pills or who are managing diabetes through diet should be seen at least every four to six months. Visits that are more frequent may be necessary if your blood glucose is not well managed, or if complications of diabetes are becoming worse.

Generally, your doctor needs to know how well your diabetes is managed and whether diabetic complications are starting or getting worse. Therefore, at each visit, provide your doctor with your home blood sugar monitoring record and report any symptoms of hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar).

Your doctor also should be informed of any changes in your diet, exercise, or medicines and of any new illnesses you may have developed. Tell your doctor if you have experienced any symptoms of eye, nerve, kidney, or cardiovascular problems such as:

• Blurred vision
• Numbness or tingling in your feet
• Persistent hand, feet, face, or leg swelling
• Cramping or pain in the legs
• Chest pain
• Shortness of breath
• Numbness or weakness on one side of your body
• Unusual weight gain

If you have diabetes, your lab tests should include:

• Hemoglobin A1c
• Urine and blood tests for kidney function
• Lipid testing, which includes cholesterol, triglycerides, HDL, and LDL
• Thyroid and liver tests as needed

 

Who Is On Your Diabetes Care Team? - Part 1

Many people do not have a diabetes care team, yet when I ask them if they have an eye doctor and a dentist, most admit they do have these doctors. Then I have to ask if they have even told the eye doctor and dentist that they have type 2 diabetes. Some admit they have not and some say why should they let these doctors even know this. This attitude I do not understand as they should have informed them after diagnosis to enable the eye doctor to have a baseline for measuring changes in eye sight and possible eye diseases.

The eye doctor will be either an ophthalmologist (a doctor who can treat eye problems both medically and surgically) or an optometrist (someone who is trained to examine the eye for certain problems, such as how well the eye focuses; optometrists are not medical doctors).

The dentist should know to have a baseline to keep alert for signs of peridontal disease and other teeth problems. The more these two doctors know, the better they will be able to watch for diabetes problems. I know that I have these two people as part of my diabetes care team. It did take dismissing the original two and replacing them, but it was needed. Keep in mind, though, that you are the most important member of your diabetes care team. Your health care team is available to help you manage your diabetes and maintain your good health.

Always remember that you are number one, you are the most important member of your diabetes care team. Only you know how you feel. Your diabetes care team will depend on you to talk to them honestly and supply information about your body. Monitoring your blood glucose is an important part of effective therapy. This will tell your doctors whether your current treatment is effective or not.

Other members of your diabetes care team will depend on the medication or medications you are taking and how important you feel they can help you with your diabetes care and health.

A Primary doctor: Your primary care doctor is the doctor you see for general checkups and when you get sick. This person is usually an internist or family medicine doctor who has experience treating people with diabetes. Because your primary care doctor is your main source of care, he or she will probably coordinate your care. Many people living in rural areas may only have this doctor plus the two above and none of those below.

Dietitian or Nutritionist: A dietitian or nutritionist is trained in the field of nutrition for people with diabetes. Because food is a key part of your diabetes treatment, this person is very important. This specialist will help you figure out your food needs based on your weight, lifestyle, medication, and other health goals (such as lowering blood glucose levels and blood pressure). Note: Whole grains, especially wheat and rice, should not be part of the food recommended as these will generally increase your blood glucose more than desirable. This person should not recommend a food plan that is high in carbohydrates and low in fat. If this happens, find a different person.

Nurse educator: A nurse/educator or a diabetes nurse practitioner is a registered nurse (RN) with special training and background in caring for and teaching people with diabetes. Nurse educators often help you learn the day-to-day aspects of diabetes self-care. If you live in an area without this specialist, know that you will need to spend time on the internet learning about diabetes on your own.