A good health care team is key to staying well when you or your child has diabetes. According to the American Diabetes Association, a diabetes care team should include:
The patient. This is the most important member of the 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 sugar tells your doctors whether your current treatment is controlling your diabetes well. By checking your blood sugar levels, you can also prevent or reduce the episodes of hypoglycemia (low blood sugar) you have.
Primary doctor. Your primary care doctor is who 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, too. Your child’s regular pediatrician will make sure that all parts of your child’s health care are managed and can make referrals to other specialists.
Because your primary care doctor is your main source of care, they will most likely head up your diabetes care team.
Endocrinologist. An endocrinologist is a doctor who has special training and experience in treating people with diabetes. You should see yours regularly.
Dietitian. A registered dietitian (RD) is trained in the field of nutrition. Food is a key part of your diabetes treatment, so yours will help you figure out your food needs based on your weight, lifestyle, medication, and other health goals (like lowering blood fat levels or blood pressure).
Nurse educator. A diabetes educator or 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 with the day-to- day aspects of living with diabetes.
Eye doctor. Either an ophthalmologist (a doctor who can treat eye problems both medically and surgically) or an optometrist (someone who is trained to handle primary healthcare of the eye, such as how well the eye focuses or helping diagnose more severe problems; optometrists are not medical doctors) should check your eyes at least once a year. Diabetes can affect the blood vessels in the eyes, which can lead to losing your sight. Children with type 1 diabetes should get a dilated eye exam 5 years after diagnosis or by age 10, whichever comes first.
Podiatrist. For anyone with diabetes, which can cause nerve damage in the extremities, foot care is important. A podiatrist is trained to treat feet and problems of the lower legs. These doctors have a Doctor of Podiatric Medicine (DPM) degree from a college of podiatry. They have also done a residency (hospital training) in podiatry.
Dentist. People with diabetes are at somewhat greater, and earlier, risk of gum disease. The excess blood sugar in your mouth makes it a nice home for bacteria, which can lead to infection. You should see your dentist every 6 months. Be sure to tell your dentist that you have diabetes.
Exercise trainer. No matter what kind of diabetes you have, exercise should play a major role in managing it. 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.
Mental health professional. Usually a social worker or psychologist, this expert can help you and your child handle the major lifestyle changes that come with diabetes.
How Often Should I See My Doctor?
People with diabetes who use insulin shots usually see their doctor at least every 3 to 4 months. People who take pills or who are managing their diabetes through diet alone should have an appointment at least every 4 to 6 months.
You may need to go more often if your blood sugar isn't controlled or if your complications are getting worse.
What Does My Doctor Need to Know?
Generally, your doctor wants to understand how well your diabetes is controlled and whether diabetic complications are starting or getting worse. Therefore, at each visit, give your doctor your home blood sugar monitoring record and tell them about any symptoms of hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar).
Also let your doctor know about any changes in your diet, exercise, or medicines and any new illnesses you may have gotten. Tell your doctor if you've had 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
What Lab Tests Should I Have?
When you have diabetes, you should get regular lab tests:
- Hemoglobin A1c
- Urine and blood tests for kidney function
- Lipid testing, which includes cholesterol, triglycerides, and HDL
You may need thyroid and liver tests, too.