Building Your Diabetes Healthcare Team
Your primary care physician can probably handle the varied aspects of your diabetes treatment plan—but that doesn't mean he or she can do it alone. Because even basic healthcare is more complicated in people with diabetes, it's better to have a team of professionals who have specialized knowledge about various aspects of the disease.
Your ideal team captain is a good primary care physician—a generalist or internist—with experience treating diabetes. In some cases, particularly with type 1 diabetes, you may need a board-certified endocrinologist—a physician with special training and expertise in managing conditions caused by abnormal hormone secretions (remember that insulin is a hormone).
Whether a generalist or specialist should manage your diabetes care depends on your particular case and who is available. The "proof is in the pudding," and in this case, it depends on whether you are being checked regularly—for instance, with a hemoglobin A1c test—and if you are doing well.
If you aren't being checked or your doctor doesn't seem to take diabetes seriously, it may well be time to move on to another physician. But if your hemoglobin A1c is in a good range and you are doing well, then stick with your doctor.
People on your diabetes healthcare team may include:
- Your endocrinologist or primary care physician (depending on who is the "team leader")
- A pharmacist
- A diabetes nurse educator, a person with a Certified Diabetes Educator (CDE) credential who specializes in providing instruction and advice on day-to-day diabetes management
- A registered dietitian to help you plan meals
- An ophthalmologist to monitor eye changes that could signal retinopathy (eye damage)
- A podiatrist (foot doctor) to check your feet and lower legs for cuts and sores, which often fail to heal and can lead to amputations in people with diabetes
- An exercise physiologist to give advice on an exercise program
- Mental health professionals to help you deal with the emotional stress of living with diabetes.
In your particular case and depending on where you live, some of these "team members" may not be necessary or available. If possible, however, consider working with a CDE. These individuals are often the most knowledgeable about diabetes care and can help you a lot. They typically work within an accredited diabetes education program. The American Association of Diabetes Educators (AADE) provides a database of AADE-accredited Diabetes Education Programs at www.diabeteseducator.org.