Who Makes Up Your Diabetes Management Team

Diabetes is a serious disease with potential complications, such as heart and kidney disease and peripheral neuropathy. That is why you want to work with a team of diabetes healthcare professionals to develop a plan to keep your diabetes under control and prevent or minimize complications.

Even with a team of competent diabetes healthcare professionals, the American Diabetes Association (ADA) stresses that you are the most important member of your diabetes care team. You live with the disease and so you know how you feel and what you are capable and willing to do. As such, according to the ADA, you make the choices about:[1] 

• When and how you take medicine or inject insulin, if prescribed
• When you check your blood glucose (blood sugar) and how you track the results
• What food you make and eat
• When and how often you exercise

You also need to keep your diabetes healthcare team posted if you see changes or see signs of potential problems.

Who makes up your diabetes healthcare team

Among the diabetes healthcare professionals on your team, you may work with:

Primary Care Provider (PCP): You want to see your PCP, whose staff will include nurse practitioners and physician assistants. From this team, you will get routine medical care, which includes physical exams, lab tests and prescriptions for medications. The team will help you develop a plan to manage your diabetes daily, which includes what your target blood sugar should be, if you should lose weight, what foods you should eat and what medications you need to take, among other issues. Your PCP will refer you to other medical specialists as necessary.

Endocrinologist: An endocrinologist is another physician among diabetes healthcare professionals who may be part of your team. Endocrinologists specialize in diseases that affect endocrine gland disorders, such as diabetes. (The endocrine system produces hormones, including insulin.)  For some people, an endocrinologist may be the primary care doctor to manage diabetes.

Certified Diabetes Care and Education Specialist (CDCES): A CDCES is a diabetes healthcare professional who will provide you with diabetes self-management education and support. They have extensive training and experience with people who have diabetes and have passed a credentialed board exam.

Your diabetes education specialist can create a daily diabetes self-management plan that includes how to monitor your blood glucose level, what foods you should eat, how your medications work and even how to deal with the emotional challenges of living with a chronic disease.

Registered dietician:  As an expert in nutrition, a registered dietician will work with you to make healthy food choices to manage your blood glucose level and reach and achieve body weight goals.  In doing so, a registered dietician can help you delay or prevent diabetes complications.

Podiatrists: A podiatrist is certified and trained to prevent, diagnose, and treat conditions associated with the foot and ankle.  When you have diabetes, taking care of your feet is critical. Foot complications affect more than 20 percent of patients treated with diabetes and the ADA reports that 20 percent of patients with diabetes are hospitalized because of foot problems.[2]

Ophthalmologist or optometrist: Retinopathy, which can result in vision loss and blindness, is common among diabetics. You want to have a comprehensive eye exam by an ophthalmologist (a medical doctor specializing in eye and vision care) or an optometrist (provides primary vision care) when you are diagnosed and afterwards annually unless you need more treatment because of the rapid spread of retinopathy.

Dentist: Your diabetes may cause a higher risk of gum disease, which makes your dentist part of your diabetes healthcare team. You want to let your dentist know your condition.

Mental health professional: Among diabetes healthcare professionals, a mental health professional can be of significant help. For some, a diagnosis of diabetes can set off a grieving process.[3] Your previous normal life and all its activities may be turned upside down. A mental health expert can help you manage the emotional issues that come with having a chronic disease.

Pharmacist: A pharmacist can help answer questions about what is in a medication and how it can affect blood sugar. They also can advise how medications interact with each other.

Questions for your diabetes healthcare team

Once you have established your diabetes healthcare team, the CDC recommends the five following questions to make sure you are on track managing your diabetes.

1)      How do I manage my ABCs, which include A1C test to measure blood sugar, blood pressure, and cholesterol?  Also stop smoking or do not start.

2)      How will I know if my medications are working?

3)      When and where can I learn more about managing diabetes?

4)      Which vaccines should I get?

5)      When should I schedule health care appointments?[4]

Your diabetes healthcare team is indispensable for managing your disease. Choose doctors who have the expertise to treat your condition and who you trust.