Your Health Care Team

You are the most important member of your health care team.

You are the one who has diabetes and takes care of it every day. You are the only one to know your feelings and what you are able and willing to do. You exercise, prepare and eat meals, take medications and/or insulin, check your blood glucose level and register it and you are the first to notice any problems. Your relationship with your healthcare team is really important, but don’t forget that this highly depends on your collaboration, talk to them honestly and tell them how you feel.

Some of the professionals that can collaborate with you in your healthcare team are:

The primary care provider: s/he may be a primary care or family practice physician, and they are the one who sees you for checkups and when you are sick. An endocrinologist is specialized and trained in diseases like diabetes, but you may not have an easy access to one. In that case look for family doctors or primary care doctors that have experience treating diabetes. Your primary care doctor may refer you to other specialists or other team members.
If you need to find a new doctor you may need to spend some time getting to know them. Make sure you are comfortable when talking about the details of your health and lifestyle. You may acquire the information that you need by asking:

  • Do you have special training in diabetes?
  • Are most of your patients people with diabetes? Do you see more people with type 1 or type 2 diabetes?
  • What tests will you do at regular office visits? How often will you order these?
  • What days are you not here? Who covers on nights and weekends?
  • What are your fees? Do you accept my insurance plan?
  • Are you associated with other diabetes care professionals, so I will benefit from a health care team?
  • Do you refer to an educator or dietitian?

Your doctor’s support is important! After a first visit ask yourself if the doctor really listen to your concerns, if they were concerned about your diabetes control and answered all of your questions.

Nurse Educator: 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. 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

Registered Dietitian: A registered dietitian (RD) is trained in nutrition. You want to be sure to work with an RD who has training and experience with diabetes. If your doctor does not work with a dietitian, ask him to refer you to one.
Your dietitian helps 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). Even if you are not new to diabetes, a visit to the dietitian can help as our food needs change as we age. Nutrition guidelines for people with diabetes also change from time to time.
Dietitians can also help you learn how the foods you eat affect your blood sugar and blood fat levels. They can help you with the following:

  • Balancing food with medications and activity
  • Reading food labels
  • Making a sick day meal plan
  • Planning meals
  • Planning for eating out and special events
  • Including ethnic or foreign foods into your meals
  • Finding good cookbooks
  • Making food substitutions

Endocrinologist: An endocrinologist is a doctor who specializes in treating diabetes and other diseases of the “endocrine system” — the body’s system of glands that produce hormones that control the way the body works. The pancreas is part of the endocrine system, and insulin is one of the key hormones the body needs to function properly. Besides diabetes, endocrinologists treat diseases involving the bones, the pituitary gland, and the thyroid and adrenal glands.
Many people with diabetes may never need to see an endocrinologist in order to take good care of their diabetes. Most people with type 1 diabetes do see an endocrinologist, especially when they are first diagnosed, and many people with type 2 diabetes may see an endocrinologist if they are having trouble getting their diabetes under control or are developing severe complications.

Eye Doctor: 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 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. Be sure your eye doctor is familiar with how to spot and treat diabetic eye disease. It’s a good idea to ask:

  • How many of your patients have diabetes?
  • Do you perform eye surgery?
  • Will you send regular reports to my primary care or diabetes physician?

Social Worker/Psychologist/Psychiatrist/Marriage and Family Therapist: Mental health professionals help with the personal and emotional side of living with diabetes. Social workers 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 few sessions with a psychologist might help during a stressful time. On a long-term basis, a psychologist might help work on more lasting problems.
A psychiatrist is a medical doctor who can prescribe medication to treat physical causes for emotional problems. Psychiatrists also provide counseling.
Marriage and family therapists can help you with personal problems in family and marital relationships and problems on the job.

Podiatrist: 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 be checked by your primary care doctor or a podiatrist. Do not try to fix these yourself, because you could cause an infection. Do inspect your feet daily for signs of trouble. Podiatrists treat corns, calluses, and more serious problems. Ask your podiatrist:

  • How many of your patients have diabetes?
  • Are you familiar with the foot problems diabetes can cause?
  • Will you work with my primary care doctor, if needed?

Pharmacist: A pharmacist has a wealth of information on medicines: what’s in them and how they interact with each other. Pharmacists are highly trained professionals who must know about the chemistry of the products they dispense and what effects, both good and bad, medications have on the body. Therefore, they can also give advice on whether and how any medication you take for your diabetes or other conditions could or will affect your blood glucose levels. It is important to find a pharmacy you like and to stick with it. This way, the pharmacist can keep an accurate and up-to-date profile of your medical history, allergies, and medications.

Pharmacists do more for you than fill your prescriptions. They alert you to the potential common or severe side effects of any drug you are going to take. With each new prescription, they can review your medication profile to see if any of your current medications might interact with your new prescription. So, in addition to asking your diabetes care provider, you can ask your pharmacist to recommend over-the-counter medicines for colds or other minor illnesses. For example, if your pharmacist knows you take a sulfonylurea, he or she may recommend a cold medicine with little or no alcohol to avoid any possible interaction between the two medications.

Dentist: 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. See your dentist every six months. Be sure to tell your dentist that you have diabetes.

Exercise Physiologist:Exercise plays a major role in your diabetes care, no matter which type of diabetes you have. Exercise can help lower blood sugar, help your body to use insulin better, and help control your weight. It can also improve your blood fat levels, reduce stress, and improve your overall fitness level. Even if you have diabetic complications, ask your doctor about safe exercises you can do.
The best person to help you and your doctor plan your fitness program is someone trained in the scientific basis of exercise. Your doctor can help you look for someone.

Always get your doctors approval for any exercise program.

You are the most important member of your health care team.

You are the one who has diabetes and takes care of it every day. You are the only one to know your feelings and what you are able and willing to do. You exercise, prepare and eat meals, take medications and/or insulin, check your blood glucose level and register it and you are the first to notice any problems. Your relationship with your healthcare team is really important, but don’t forget that this highly depends on your collaboration, talk to them honestly and tell them how you feel.

Some of the professionals that can collaborate with you in your healthcare team are:

The primary care provider: s/he may be a primary care or family practice physician, and they are the one who sees you for checkups and when you are sick. An endocrinologist is specialized and trained in diseases like diabetes, but you may not have an easy access to one. In that case look for family doctors or primary care doctors that have experience treating diabetes. Your primary care doctor may refer you to other specialists or other team members.
If you need to find a new doctor you may need to spend some time getting to know them. Make sure you are comfortable when talking about the details of your health and lifestyle. You may acquire the information that you need by asking:

  • Do you have special training in diabetes?
  • Are most of your patients people with diabetes? Do you see more people with type 1 or type 2 diabetes?
  • What tests will you do at regular office visits? How often will you order these?
  • What days are you not here? Who covers on nights and weekends?
  • What are your fees? Do you accept my insurance plan?
  • Are you associated with other diabetes care professionals, so I will benefit from a health care team?
  • Do you refer to an educator or dietitian?

Your doctor’s support is important! After a first visit ask yourself if the doctor really listen to your concerns, if they were concerned about your diabetes control and answered all of your questions.

Nurse Educator: 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. 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

Registered Dietitian: A registered dietitian (RD) is trained in nutrition. You want to be sure to work with an RD who has training and experience with diabetes. If your doctor does not work with a dietitian, ask him to refer you to one.
Your dietitian helps 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). Even if you are not new to diabetes, a visit to the dietitian can help as our food needs change as we age. Nutrition guidelines for people with diabetes also change from time to time.
Dietitians can also help you learn how the foods you eat affect your blood sugar and blood fat levels. They can help you with the following:

  • Balancing food with medications and activity
  • Reading food labels
  • Making a sick day meal plan
  • Planning meals
  • Planning for eating out and special events
  • Including ethnic or foreign foods into your meals
  • Finding good cookbooks
  • Making food substitutions

Endocrinologist: An endocrinologist is a doctor who specializes in treating diabetes and other diseases of the “endocrine system” — the body’s system of glands that produce hormones that control the way the body works. The pancreas is part of the endocrine system, and insulin is one of the key hormones the body needs to function properly. Besides diabetes, endocrinologists treat diseases involving the bones, the pituitary gland, and the thyroid and adrenal glands.

Many people with diabetes may never need to see an endocrinologist in order to take good care of their diabetes. Most people with type 1 diabetes do see an endocrinologist, especially when they are first diagnosed, and many people with type 2 diabetes may see an endocrinologist if they are having trouble getting their diabetes under control or are developing severe complications.

Eye Doctor: 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 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. Be sure your eye doctor is familiar with how to spot and treat diabetic eye disease. It’s a good idea to ask:

  • How many of your patients have diabetes?
  • Do you perform eye surgery?
  • Will you send regular reports to my primary care or diabetes physician?

Social Worker/Psychologist/Psychiatrist/Marriage and Family Therapist: Mental health professionals help with the personal and emotional side of living with diabetes. Social workers 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 few sessions with a psychologist might help during a stressful time. On a long-term basis, a psychologist might help work on more lasting problems.
A psychiatrist is a medical doctor who can prescribe medication to treat physical causes for emotional problems. Psychiatrists also provide counseling.
Marriage and family therapists can help you with personal problems in family and marital relationships and problems on the job.

Podiatrist: 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 be 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. Podiatrists treat corns, calluses, and more serious problems. Ask your podiatrist:

  • How many of your patients have diabetes?
  • Are you familiar with the foot problems diabetes can cause?
  • Will you work with my primary care doctor, if needed?

Pharmacist: A pharmacist has a wealth of information on medicines: what’s in them and how they interact with each other. Pharmacists are highly trained professionals who must know about the chemistry of the products they dispense and what effects, both good and bad, medications have on the body. Therefore, they can also give advice on whether and how any medication you take for your diabetes or other conditions could or will affect your blood glucose levels.
It is important to find a pharmacy you like and to stick with it. This way, the pharmacist can keep an accurate and up-to-date profile of your medical history, allergies, and medications.
Pharmacists do more for you than fill your prescriptions. They alert you to the potential common or severe side effects of any drug you are going to take. With each new prescription, they can review your medication profile to see if any of your current medications might interact with your new prescription. So, in addition to asking your diabetes care provider, you can ask your pharmacist to recommend over-the-counter medicines for colds or other minor illnesses. For example, if your pharmacist knows you take a sulfonylurea, he or she may recommend a cold medicine with little or no alcohol to avoid any possible interaction between the two medications.

Dentist: 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. See your dentist every six months. Be sure to tell your dentist that you have diabetes.

Exercise Physiologist:Exercise plays a major role in your diabetes care, no matter which type of diabetes you have. Exercise can help lower blood sugar, help your body to use insulin better, and help control your weight. It can also improve your blood fat levels, reduce stress, and improve your overall fitness level. Even if you have diabetic complications, ask your doctor about safe exercises you can do.
The best person to help you and your doctor plan your fitness program is someone trained in the scientific basis of exercise. Your doctor can help you look for someone.

Always get your doctors approval for any exercise program.


Diabetes advocacy groups

The following is a list of organizations that can provide information on diabetes. Ask your health care team to help you find other resources for information or support.

Country specific groups can be listed here.

Support groups

Diabetes can affect emotions in a direct or indirect way. Poor control of your blood sugar can make you more irritable. You may also feel different from other people because of your condition, and you may also feel resentful as a consequence. You have to adapt your daily life to diabetes planning.

As a person with diabetes you have an increased risk of depression and anxiety, and that is why your healthcare team may include a social worker or even a psychologist.

You may find it useful to talk to other people suffering from diabetes. There are support groups organized both online and in person. Even if you may not feel eager to join one or you think you are not a kind of person who can enjoy being part of it, consider that they can be good sources of information. People in support groups know about the latest treatments, and can share their own experience or other kinds of helpful practical information (i.e. carbohydrate counts for your favorite takeout restaurant).

SUPPORT GROUP: A group of people who share a similar problem or concern. The people in the group help one another by sharing experiences, knowledge, and information

In a support group, if you just found out you have diabetes you can learn from people who have lived with it for long time. You can talk about it and share how you deal with it. You may even talk about how you take care of your health, how you prepare food, and which kind of physical activities you do. Family members are also welcome, even if they do not have diabetes. This can help them to understand your situation, and how to better help you.

Ask your doctor if they are aware of a local support group you may join!

It can help to talk with other people who have problems like your own.

Support

To live with diabetes can be difficult and frustrating, and you know it well. Sometimes your blood sugar level my rise even if you have done everything properly. However if you stick to your diabetes management plan you will likely see a positive difference in A1C during your visit with your doctor.

These situations, as well as the normal daily diabetes management, can become overwhelming. It can be helpful to find somebody to talk with. Your healthcare team can be a support, and it is made up of many different specialists, but you may also want to try a support group to share your frustrations as well as your successes with other people. These people can understand your situation, because they live it themselves and it can be very helpful. You may find new tips thanks to meeting with other people that manage diabetes every day.

Ask your doctor if they are aware of a local support group you may join!