- Your diabetes health care team
- You: the most important member in your diabetes care
- Primary care doctor: needs experience treating people with diabetes
- A dietician: food is a key part of diabetes treatment
- Nurse educator: special training to care and teach people with diabetes
- Eye Doctor: diabetes can affect the eyes
- Podiatrist: foot care is important for those with diabetes
- Dentist: people with diabetes must take greater care to prevent gum disease
- Exercise trainer: exercise plays a major role in diabetes care
- How often should I see my doctor?
- What information should I give my doctor?
- What lab tests should I have done?
People with diabetes work with an extensive health care team, which may include a primary doctor, dietitian, diabetes educator, eye doctor, foot doctor, dentist and possibly an exercise trainer. But remember, you are the most important member of the team. Your health care team is available to help you manage your diabetes and maintain your good health.
According to the American Diabetes Association, your health care team should include:
You: You are the most important member of your health care team. Only you know how you feel. Your health care team will depend on you to talk to them honestly and supply information about your body. Monitoring your blood glucose is an important part of effective therapy. Doing this will allow the team to evaluate whether the current treatment is effective to attaining good control of your diabetes.
Primary doctor: Your primary care doctor is the doctor you see for general checkups and when you get sick. This person is usually an internist or general practice doctor who has experience treating people with diabetes. Ideally, an endocrinologist/diabetologist should also be seen regularly. An endocrinologist is a doctor who has special training and experience in treating people with diabetes. Because your primary care doctor is your main source of care, he or she will most likely head up your health care team.
Dietician: A registered dietitian (RD) is trained in the field of nutrition. Because food is a key part of your diabetes treatment, a dietitian is very important. Your dietitian helps you figure out your food needs based on your weight, lifestyle, medication and other health goals (such as lowering blood fat levels or blood pressure).
Nurse educator: A nurse/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 learn the day-to-day aspects of diabetes self-care.
Eye Doctor: This doctor is another key member of your health care team because diabetes can affect the blood vessels in the eyes. The eye doctor will be either an ophthalmologist (doctor who can treat eye problems both medically and surgically) or an optometrist (someone who is trained to examine the eye for certain problems, such as how well the eye focuses; optometrists are not medical doctors). You should see your eye doctor at least once a year.
Podiatrist: This health professional is trained to treat feet and problems of the lower legs. For anyone with diabetes, foot care is important. Podiatrists 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 glucose in your mouth makes it a nice home for bacteria, which can lead to infection. You should see your dentist every six months. Be sure to tell your dentist that you have diabetes.
Exercise trainer: Exercise plays a major role in your diabetes care, no matter what kind of diabetes you have. 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.
People with diabetes who are treated with insulin shots generally should see their doctor at least every three to four months. Those who are treated with pills or who are managing diabetes through diet should be seen at least every four to six months. More frequent visits may be necessary if your blood glucose is not controlled or if complications of diabetes are worsening.
Generally, your doctor needs to know how well your diabetes is controlled and whether diabetic complications are starting or getting worse. Therefore, at each visit, provide your doctor with your home blood glucose monitoring record and report any symptoms of hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose).
Your doctor also should be informed of any changes in your diet, exercise or medicines and of any new illnesses you may have developed. Tell your doctor if you have experienced any 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
Reviewed by Certified Diabetes Educators in the Department of Patient Education and Health Information and by physicians in the Department of Endocrinology at The Cleveland Clinic.
Edited by Brunilda Nazario, MD, October 2004.
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