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Your Diabetic Health Care Team

You may be inclined to think you can’t actually choose a doctor or health care team to help you manage your diabetes, but like many other responsibilities for diabetes care, it’s up to you to know what’s necessary and to make some demands if you’re not getting the support you need.

Here’s a quick listing of medical resources you can take advantage of:

  • Primary physician: Most people with type 2 diabetes work with a primary physician, who prescribes medication and routinely monitor for signs of diabetes-related complications in physical exams and laboratory work. A primary physician may or may not have access to in-house diabetes-related support resources like a registered dietitian, certified diabetes educator, or an organized patient support group.

    Your primary physician should, however, be willing and anxious to recommend or formally refer you elsewhere for these very important support services.

  • Endocrinologist or diabetologist: These specialized physicians are most likely working with people with type 1 diabetes, or people with type 2 diabetes who have poorly controlled blood glucose or diabetes-related complications. They are the experts in diabetes treatment and will likely have in-house health professionals to help with diet, exercise, blood glucose monitoring, and emotional support.

  • Registered dietitian: Because food and eating habits are so closely connected with weight, blood glucose, and the risk for heart disease, seeing a registered dietitian, an expert in medical nutrition therapy, is very important. Because this book is about food and diabetes, the advantages to seeing a registered dietitian are discussed in detail later in this section.

  • Pharmacist: Your pharmacist is perhaps your best resource for education about medications, not only those prescribed for diabetes, but also those prescribed for other conditions. Most important, your pharmacist knows how your variety of medications could interact. Diabetes is so prevalent now that many pharmacists are diabetes educators.

  • Certified diabetes educator: A wide range of health care providers — physicians, registered nurses, registered dietitians, pharmacists, clinical psychologists, podiatrists, and others — have studied and taken a comprehensive certification examination to provide a broad range of education and support to people with diabetes.

    Spending time with a certified diabetes educator, individually or in a group, for diabetes self-management education (DSME) can be helpful in tying together the many medical and lifestyle responsibilities patients struggle to balance.

  • Podiatrist: Getting regular foot exams and early treatment of potential problems by a podiatrist can literally be a limb saver. The loss of sensation and circulation problems makes your feet an easy target for minor infections that can become difficult to control. Anyone with neuropathy (nerve damage) should see a podiatrist regularly.

  • Dentist: Diabetes can increase the risk of gum disease, so regular visits to your dentist for examination and cleaning are very important.

  • Mental health professional: Diabetes can be overwhelming, and people with diabetes are significantly more likely to experience depression than the general population. Diabetes can be distressing. More than 41 percent of the participants in the DAWN study reported “poor well being” even decades beyond their diagnosis.

    Distress at diagnosis is much higher. Depression and stress deserve attention in their own right, but need particular focus where diabetes is concerned because feeling depressed can diminish with self-care behaviors. Only 10 percent of the DAWN study participants reported ever having sought psychological treatment — don’t hesitate to get help with the emotional stresses diabetes can bring.

Make sure each of your resources sends a report to your primary physician so that she knows what’s being done for you.

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