Diabetes -- whether type 1 or type 2 -- is an unusually complicated illness. It threatens virtually every organ in the body and requires a constant balance of diet, exercise and medication. The emotional burdens can be overwhelming as well. The reality is that, according to the Journal of the American Medical Association, fewer than one in 10 Americans with diabetes have their glucose, cholesterol and blood pressure under good control.
While there are no easy solutions, a team approach to diabetes care offers the best chances for success.
Begin with a Doctor
First, start with a good doctor, either an endocrinologist (a specialist who treats diseases like diabetes that affect the endocrine glands) or a primary care physician. Experience is critical for treating any disease, but what’s different about diabetes is the surge of new drugs and medical devices flooding the market. Doctors cannot truly understand how well these products work -- or who will benefit from them -- unless they have ample opportunity to prescribe medications and monitor patients who have diabetes. Ask fellow diabetics for a recommendation or check with a local branch of the American Diabetes Association.Diabetes Educators: A Must on Any Team
Diabetics also need a diabetes educator. This person normally has far more time than a doctor to explain the details of diabetes, help diabetics learn to manage their condition and stay informed about the basic tests (e.g., hemoglobin A1c, blood pressure and cholesterol) that measure progress. Diabetes is all about problem solving, and a good educator should provide enough guidance to help resolve any issues that a diabetic might face. A good educator is a great resource. Look for one through the American Association of Diabetes Educators.Educators come from different professional backgrounds -- some are nurse practitioners, some have advance nursing degrees, others may be pharmacists. Standards to become a certified diabetes educator are rigorous, so don’t get stuck on one particular degree. Interview several and make sure the personal fit is right. An educator will be a good source of referrals for doctors or nurses as well as a source of motivation and support.
Nutritionists: For Help with Your Diet
A nutritionist, one who can map out a diet that is both healthy and satisfying, is also important. No one with diabetes should ever feel deprived or hungry; sometimes it just takes a little bit of culinary creativity. A good nutritionist can provide just that. Doctors and diabetes educators can often recommend a nutritionist.Eye Doctors, Cardiologists and Other Specialists
Diabetes is the leading cause of blindness for adults in the United States, but eye problems can be avoided with the proper preventive care. Diabetics should get an eye exam every year without fail from a trusted eye doctor. Other specialists, such as heart, foot and kidney experts, may be needed down the road. Again, a primary care physician is a good place to seek a referral for such specialists.An Exercise Physiologist
An exercise physiologist is an expert in the effect of exercise on the human body. If your doctor doesn’t raise exercise as a topic, that’s a red flag. An exercise physiologist may or may not be necessary, but discussion about exercise definitely is. A referral from a health care provider is often a good place to begin the hunt for an exercise physiologist.Friends and Family Play Critical Roles
Don’t forget a support group! Family and friends who try to understand diabetes can be of great help, but there is something to be said for reaching out to others with diabetes -- either in person or online -- for encouragement. Whether they are friends, family members or others with diabetes, these people are very much part of a health care team. Check online to see what support groups are available locally, or ask a health care professional for a recommendation.Who Pays for a Diabetes Medical Team?
Reimbursement can be complicated, but diabetics should remember that they themselves are their best advocates. If one has private insurance or Medicare, all primary doctors and specialists should be covered. An educator can offer advice on this front. Whether or not a diabetic can be reimbursed for a diabetes educator or an exercise physiologist will depend on his or her insurance plan. More and more are covering diabetes education.All-Star Cast
The great thing about a health care team is that all its members are working to help a diabetic succeed. However, this group of professionals can only carry one so far. Even with an all-star cast, the responsibility ultimately falls on the diabetic to make the right decisions.Sources:
Saydah, Sharon, Judith Fradkin and Catherine Cowie. “Poor Control of Risk Factors for Vascular Disease Among Adults With Previously Diagnosed Diabetes.” Journal of the American Medical Association. 21 Jan. 2004.
<http://jama.ama-assn.org/cgi/content/full/291/3/335>
"National Diabetes Fact Sheet." National Center for Chronic Disease Prevention and Health Promotion . 09 June 2005. Centers for Disease Control and Prevention. 10 Sep. 2007.
<http://www.cdc.gov/diabetes/pubs/factsheet.htm>.
