Your "regular" or primary care doctor will oversee the management of your diabetes, and refer you to other team members, such as foot and eye doctors, diabetes educators, dietitians, and exercise specialists. (Note that many insurance plans require a doctor's referral for visits to other health specialists.)
Your Diabetes Treatment Team
If you need specialized help, your doctor might refer you to an endocrinologist — a doctor specially trained in problems dealing with different hormones, such as insulin, or a diabetologist, a doctor with special training in diabetes. If you become pregnant, your doctor will refer you to an obstetrician. If you develop kidney problems, you'll need to see a kidney specialist. If you have blood flow problems, you'll need to add a vascular specialist to your team. Your primary care doctor will coordinate with all the members of your team to ensure everyone is working well together.
One of the key specialists you will likely meet is a diabetes educator. He or she will work with you on your condition and provide information about the day-to-day aspects of managing your diabetes, including all the things you can do to help yourself. Your diabetes educator will help you:
- understand what diabetes is
- learn about the importance of eating healthy, exercising regularly and checking your blood glucose
- learn how to use diabetes medications safely and correctly
- learn how to give yourself insulin, if needed
- understand how to monitor your treatment
- learn how to know when your blood glucose is too low or too high and how to treat it
- learn to take care of yourself on days when you don't feel well enough to follow your regular plan
- stay healthy if you are pregnant
Eating right is an important part of managing your diabetes. For this reason, a registered dietitian — who might also be a diabetes educator — is a key member of your diabetes management team. Your dietitian can teach you about how the foods you eat affect your blood glucose and cholesterol levels. He or she can also teach you how to read and use the nutrition facts from food labels, plan healthy and flavorful meals, make healthy choices in restaurants and handle special situations when you can't follow your regular diabetes routine. These times may include the holidays, when you travel or are sick, or when you have low blood glucose, called hypoglycemia.
It is a good idea to see a dietitian twice a year or when you are having trouble or have a change in lifestyle. During your visits:
- show your dietitian your blood glucose diary
- discuss any episodes of very low or high blood glucose that you've had
- tell the dietitian about any problems you have with your meal plan or with reaching your goals, such as losing excess weight
Sharing this information can help your dietitian adjust your meal plan to better meet your needs.
When you have diabetes, you're at greater risk for developing eye diseases that can lead to blindness, including diabetic retinopathy, cataracts and glaucoma. If you have changes in your vision, your eye doctor will treat the problem or refer you to another doctor with special training in that area. There are two types of eye doctors who can examine your eyes and diagnose your visual problems. Optometrists will likely treat your eye disorders with visual aids, glasses and contact lenses, and sometimes medicine. Opthamologists may use all those forms of treatment, plus surgery, if needed.
You can help prevent damage to your eyes by having them examined at least once a year by an eye doctor. If you have problems with your eyes, get treatment quickly to prevent and delay further damage. Your exam should include dilation, which is a widening of the pupil that allows the doctor to see more of your retina, where damage may occur because of having diabetes.
Foot problems are a leading cause of hospitalization for people who have diabetes. Your primary care doctor should look at your feet at each diabetes visit. He or she will look for redness, sores, blisters and any visible problems. At least once a year, your doctor should also check the sensation in your feet. This is called a neurological exam. At that time, the doctor will also check the pulses in your feet to check your circulation. If your doctor finds any problems, he or she may refer you to a foot doctor, called a podiatrist.
Your foot doctor will determine how often you should schedule visits. Your foot doctor will use a variety of tests to check foot circulation, sensation and structure. He or she will look for changes that indicate foot problems. Your foot doctor will also help you develop good foot care habits to prevent problems.
Mental Health Professional
Diabetes is a chronic disease. It can affect nearly every part of your body and much of your lifestyle. As a result, it can effect how you feel about yourself. You may need help coping with your feelings about living with a chronic disease, and with managing your diabetes during especially stressful times. If you have trouble coping emotionally, ask your healthcare provider to refer you to a mental health professional. Seeing this type of specialist can help you feel better, both emotionally and physically.
Mental health professional is a general term that can refer to anyone who has specialized training in helping people talk through their problems. They include social workers, psychologists and psychiatrists, as well as others.
Social workers can help you deal with the emotional problems you may be having with your family, work or school. They can also guide you to resources for help with medical or financial needs. Clinical psychologists are trained in individual, group and family psychology. Psychiatrists are medical doctors with special training in emotional problems. They can provide counseling and prescribe medications for dealing with emotional issues. There are also registered nurses who can provide counseling and will help you learn more about both the physical and emotional aspects of your diabetes.
Physical Activity Specialist
Physical activity is an important part of managing diabetes. It can help lower your blood glucose, help your body use insulin better, help you lose excess weight, improve your cholesterol levels, reduce stress and make you feel better. Because it's important to exercise safely, you should develop your physical activity regimen with someone trained in the science of exercise. Your doctor or diabetes educator may help you with this. Not everyone who has diabetes sees a specialist about activity.
Everyone needs to pay attention to his or her dental health. People who have diabetes are at greater risk for gum problems, so they particularly need to see dentists. When you have gum disease, germs can destroy your gums and the bone around your teeth. People who have diabetes also have more mouth infections, fungal infections and dry mouth, which can increase the risk of cavities and other problems. Get any problems treated without delay.
If you have diabetes, you should see your dentist at least every six months. Be sure to let your dentist know you have diabetes so that he or she can be on the alert for problems.
Written by award-winning health writer Bobbie Hasselbring
Reviewed by Beth Seltzer, MD
Last updated June 2008