Ask The Expert
Education, Care & Research

It breaks my heart to read about your problems, as I know you must feel so frustrated. It is unfortunately true that not all areas of the country have easily accessible diabetes programs and specialists. Please realize that typically the doctor does not have much time to spend with each patient—yet you need and deserve some attention to these problems. But generally, most doctors who take care of people with diabetes also rely on diabetes nurse educators and dietitians—many of whom would teach you self-management skills, as well as perhaps work with your doctor to assist in dosage management or suggest a different insulin regimen if that were necessary.

How to Find a Good Doctor and a Diabetes Team:

• There are a number of resources available, so please read the following suggestions as well as check out the related links below.
• Joslin Diabetes Center provides an excellent summary about understanding the role of your doctor as well as how to find good care.
• The National Standards for Diabetes Care clarify that you do indeed have the right to be able to discuss your condition and review your glucose records with your healthcare team.
• You could call your local hospital to see if they have a diabetes outpatient diabetes program.
• If you know anyone in your community with diabetes, you can ask them for their recommendation. Or if you are seeing any other doctors for other conditions, you might ask them as well.
• You can call your local American Diabetes Association (ADA) listed in the phone book; if there isn’t one in your area, then there would be one for your state. They would have a list of doctors who manage people with diabetes.
• Although it would be ideal to see a diabetes specialist, who is called an Endocrinologist or Diabetologist, the reality is that there aren’t enough diabetes specialists to take care of all the people with diabetes, so many people do fine with a doctor who has an interest in diabetes, providing they also get further assistance from other members of a diabetes team, such as the nurse and dietitian.

• The American Diabetes Association - Education Programs
  • Generally, diabetes education programs that are recognized by the American Diabetes Association are considered reputable as they meet certain national standards and guidelines. So by calling one near you, you could ask them for physician recommendations. Also you could ask them for assistance in learning more about diabetes self-management skills.
• Find a Diabetes Educator
  • The American Association of Diabetes Educators (AADE) is a multidisciplinary organization representing over 10,000 healthcare professionals who provide diabetes education and care.
• Find a Dietitian
  • The American Dietetic Association’s Nationwide Nutrition Network is a national referral service that links consumers, physicians, food manufacturers, distributors or restaurant owners or managers with dietetics professionals. This site also provides nutritional information.
    

How to Get the Most from Your Visits:
Once you find the diabetes team that is right for you, here are some tips to help you get the most from your visits:

• Bring your insurance card and past medical history information with you.
• Write out a list of your concerns to review with your diabetes team.
• If possible, bring a companion to listen and take notes.
• Be up front with your team and express your concerns and goals.
• Take off your shoes/socks at each visit to ensure that your feet are checked at each visit.
• Be as specific as possible about any problems or symptoms.
• Be sure to always bring your blood glucose record book, as well as a food record if you are seeing the dietitian. Your records are only as good as the corresponding comments, so include notes explaining variations in your routine (such as exercise days, illness, stress, overeating).
• Be honest in your records and your discussion with the team—trying to please the team with "good records" will only hurt you rather than help you.
• Bring a list of all your medications (prescription and over-the-counter) to review with your doctor.
• Ask about side effects of any medication and be sure you understand how to take it.
  

Conclusion:
Although you have some work ahead of you to get established with a good diabetes team, remember that it is your job to be sure everyone is working together to provide you the best healthcare possible. Let your healthcare team know you’re serious about managing your diabetes, and that you want to be an active partner with them.

Best wishes for managing your diabetes and achieving the best control possible.