“One is the loneliest number that you’ll ever do…”
- “One” by Harry Nilsson.
Many people with diabetes feel alone in their journey, but it doesn’t have to be that way. Diabetes affects many parts of a person’s life, so having a support team on this journey can be greatly beneficial.
It is important for all people with diabetes to remember that you are the main team member since you're the only one that knows what you can and are willing to do. Diabetes can affect your ability to sleep, your appetite, your ability to focus, your ability to see and feel, your sexual performance, your work performance…the list could go on and on. Since there are so many aspects that may need some attention, it's great to get some input from people who specialize in each area. Even if you feel that their advice is overwhelming and you can't do everything, talk with them openly and honestly because that is the only way they can help you.
So, go ahead and create a partnership for better health. Even if you have had diabetes for years, things change; medicine changes, your body changes, your complications change, recommendations change. Reach out and get some support! Here’s a refresher on what’s available.
Primary Care Physician and Your Overall Health
Many already have a Primary Care Physician (PCP, Family Practice, Internal Medicine). They may have diagnosed your diabetes. However, if you do not have one, it is a good idea to get one. When looking for a PCP, make sure it's someone who you can talk with openly and whose opinion you respect. Your Primary Care Physician can work with you to coordinate your care by making sure you get to a specialist(s) when needed. Have each specialist you see send your information to your PCP, to combine all the puzzle pieces of your health. Your Primary Care Physician may also prescribe medications to treat your diabetes and do further testing to see if your diabetes has caused any complications.
Endocrinologist and Your Endocrine System
Diabetes is one of the diseases of the endocrine system, and is part of an endocrinologist’s specialty. Although you are not required to see an endocrinologist, if you have Type I diabetes or are having trouble getting your diabetes under control, your PCP may refer you to one. Don’t worry if your PCP has referred you. It does not always mean that they are not capable of treating you or that your diabetes is out of control. Some just prefer you to be managed by an endocrinologist or want you to get a second opinion of the treatment plan.
Many people with diabetes see their endocrinologists every three to six months. Since they visit so frequently, they may feel it is redundant to see their PCP and want to rely solely on their endocrinologist to manage all aspects of their medical care. If this sounds like you, please don’t assume, instead check with your endocrinologist and make sure they are comfortable with this role. Many want their patients to continue with a PCP for the none endocrine issues.
Certified Diabetes Educator (CDE) and Your Diabetes Care
A certified diabetes educator (CDE) is a health care professional who has been specifically trained in the care and treatment of diabetes. Their job is to work with you, to help you learn how to care for your diabetes. They can teach you about diabetes and what it means to your body, about your medications and how to administer them, about how to test your blood sugar and what the levels mean. Diabetes educators can also talk with you about nutrition, complications, insulin pumps and continuous glucose monitors. They can help you trouble shoot and teach you how to have you control your diabetes instead of having your diabetes control you.
Nutritionist/Registered Dietitian and Your Food
A registered dietician (RD) is someone who has been trained in nutrition. Make sure you look for one who has experience working with people with diabetes. Portion sizes and foods types can drastically affect your blood sugar control. Being diagnosed with diabetes is not a sentence to never eat the foods you love, it just means that you need to find the balance that pleases your pallet while maintaining blood sugar control. This can be done!
Again, remember to be open and honest about what you are willing to do, that is the only way the nutritionist/dietitian can help you help yourself.
Dentist and Your Teeth
People who have diabetes, especially if it is uncontrolled, have a greater risk of developing gum disease, tooth decay, ulcers and infections in the mouth. Also people with diabetes are at special risk for periodontal (gum) disease which is an infection of the gum and bone. Periodontal disease can lead to painful chewing, difficulties eating and even tooth loss.
It is recommended that you routinely brush and floss your teeth daily and see your dentist every six months.
Podiatrist and Your Feet
As a person with diabetes, you may have serious foot problems, but feel no pain, possibly caused by nerve problems or issues with the circulation to your lower legs and feet. A podiatrist can teach you how to properly care for your feet and help you to avoid foot related complications.
Take the time to check your feet each day for cuts, sores, red spots, swelling, and infected toenails. If you have trouble seeing your feet, you can use a plastic mirror to view them (you don’t want to drop a glass one and get a cut in your foot), or ask a family member or caregiver to help you. Make sure to call your doctor right away if a cut, blister or bruise on your foot does not begin to heal after one day. This is because even a small sore can turn into a serious problem if not attended to properly. Make sure you get a report sent to your PCP and endocrinologist (if you see one).
Pharmacist and Your Medication
A pharmacist can be a valuable source of information. Make sure you tell them all of the medications you take so that they can let you know if there are any interactions that you may not be aware of. They can also help you with what over the counter medications you can safely take with your prescription medications. Please take a moment to look at the Cecelia Health blog ‘Your Pharmacist Can Be Your Diabetes Educator’ by Elise Swenson.
Psychologist/Psychiatrist/Counselor/Social Worker and Your Emotions
It is not uncommon to have a shopping bag full of emotions when you are diagnosed with diabetes. Some people are fearful of the medications, the complications and the lifestyle changes. Some are scared of possible complications. Others people are angry or in denial.
Many people find it beneficial to speak with someone who can help them sort through these emotions. A social worker is another resource that can also help you work through the resources that are available to you.
Ophthalmologist/Optometrist/Retinologist and Your Eyes
The American Diabetes Association recommends that people with diabetes get a dilated eye exam every year to check for any damage to their eyes. Your eyes are full of tiny little blood vessels and diabetes can adversely affect them. If this type of damage is caught early there are many new treatments available that can help to preserve your vision. Unfortunately, if you wait until you have vision problems it may be too late. Once again it is important to make sure you get a report sent to your PCP and endocrinologist (if you see one).
Nephrologist and Your Kidneys
A nephrologist is a physician who specializes in diseases of the kidneys. Diabetes can affect your kidney function, especially if your blood sugars are uncontrolled. If your lab results show that your kidneys are feeling the effects of your diabetes, your PCP may refer you to a nephrologist for further studies and a treatment plan to help preserve your kidney function. Make sure you get a report sent to your PCP and endocrinologist (if you see one).
Your Team, Your Journey
All in all, life with Diabetes is full of ups and downs. It is a bit of a roller coaster that you don’t always have control over. However, your care and who oversees it is in your control. Take charge! Be educated. Find yourself a team of healthcare professionals who will make this ride a little smoother and a lot less lonely.
By Nancy W Barton RN, CDE
Cecelia Health Certified Diabetes Educator
American Diabetes Association