Whether you have type 1, type 2, or gestational diabetes, the success of your treatment plan depends on a good collaboration with your diabetes doctor. Here, we asked specialists in this condition—which occurs when your body either can’t produce or can’t use the hormone insulin to process blood sugar—for the lowdown on getting the best diabetes care.
1. “Expect me to be nosy.”
“I ask patients questions about how diabetes has affected them, in addition to how it is affecting their blood glucose levels,” says endocrinologist Richard Shewbridge, MD. Diabetes causes changes throughout your entire body, including your feet, your skin, your mood, and your sexual organs. Tell your doctor about all your health issues—even ones that are difficult to talk about or don’t seem related, like depression or erectile dysfunction. Treatment can help relieve them.
2. “I need to know the truth about your daily habits.”
Come clean about your diet and exercise routine, says endocrinologist Scott Isaacs, MD. If you fib about what you’re eating or how often you’re active, you’re the one whose health may ultimately suffer. “Doctors are not ‘just about the medicines’—we would rather help patients make smarter choices in these areas,” says Dr. Shewbridge.
3. “It’s never too late to make lifestyle changes.”
If you have type 2 diabetes, losing just 7% of your body weight—that’s 12 to 13 pounds, if you weigh 180—can dramatically improve your health, says endocrinologist Osama Hamdy, MD, PhD. Typically, you can do this through diet and exercise. And although weight loss and other healthy changes may be most effective soon after your diagnosis, you can reap the benefits no matter when you begin.
4. “Don’t believe everything you read or hear.”
Diabetes information is everywhere—blogs, online forums, small talk with friends and family, terrifying lawyer ads on TV. Keep in mind that everyone’s situation is different and some sources are more reliable than others, Dr. Isaacs says. Your diabetes care team can guide you toward the truth and help you make the best choices for your health.
5. “We both need continuing education.”
Your doctor should take steps to actively keep up with new research—for instance, attending continuing medical education courses or events. You should take a similar approach, advises endocrinologist Irene O’Shaughnessy, MD. “I encourage my patients to keep up with their diabetes education, and to meet with a dietitian and diabetes educator at least once a year,” she says.
6. “Don’t ‘sugarcoat’ your blood glucose readings.”
“Some patients leave off the highest (or below normal) home glucose testing readings because they may fear that the more abnormal readings may upset the doctor,” says Dr. Shewbridge. But your doctor needs to know all your numbers to adequately assess your health. “I’m not going to lecture you. I am interested in problem-solving to help turn the glucose levels around, so that the high glucose levels will not harm your body.”
7. “No symptoms? Your health is still in danger.”
Most signs of diabetes are subtle, and appear gradually over time, Dr. Hamdy says. But just because you feel fine doesn’t mean your diabetes isn’t progressing. Keep a close watch over your numbers—including your blood glucose, blood pressure, and hemoglobin A1c—to ensure you aren’t at risk for diabetes complications, such as heart disease, nerve damage, and vision problems.
8. “Taking insulin doesn’t mean you’ve failed at controlling your diabetes.”
“I hear many patients tell me they must be a ‘bad’ diabetic if they need insulin. In fact, insulin is one of the most effective ways to lower blood sugar quickly,” Dr. O’Shaughnessy says. In some cases, it’s a short-term fix for people with type 2. “However, the natural history of type 2 diabetes is that many patients ultimately need insulin, and this does not necessarily reflect anything they are doing wrong.”
9. “Don’t choose me as your doctor if you don’t like my style.”
Effective diabetes treatment requires doctor and patient to work together as a team, but your roles can vary depending on your personality, Dr. O’Shaughnessy says. Some patients want to be told exactly what to do, while others seek a healthcare partner. Take time to get to know your doctor and make sure he or she is the best fit for your needs.
10. “Not everyone needs to see an endocrinologist.”
Endocrinologists specialize in diabetes care, and everyone with type 1 diabetes should see one. But if you have type 2 diabetes, your primary care doctor can probably manage your condition, especially at first, Dr. Hamdy says. If you’re taking more than two diabetes medications; your hemoglobin A1c results remain high or unstable over time; or if you start to develop signs of diabetes complications, it’s time to see a specialist.
11. “Diabetes is a lifelong challenge …”
There’s no cure for diabetes, and avoiding its long-term health risks takes consistent effort. “Diabetes is unique in that self-management is such an important part of the treatment,” Dr. O’Shaughnessy says. Your doctor can act as a coach, motivator or resource, but the daily task of diabetes management is in your hands.
12. “ … but if you control diabetes, it won’t control you.”
With proper management—including blood glucose monitoring, a proper diabetes diet, and regular visits to your diabetes doctor—people with the condition can live full, healthy lives. And don’t fret if you take a wrong turn or two along the way. “It’s not the end of the world. This is a slowly progressive disease, and you can turn things around and get back on the right path,” Dr. Hamdy says.
Healthgrades would like to thank the following physicians for their contributions to this content:
Osama Hamdy, MD, PhD, is medical director of Joslin Diabetes Center’s Obesity Clinical Program, an instructor at Harvard Medical School, and the author of The Diabetes Breakthrough.
Scott Isaacs, MD, is medical director of Atlanta Endocrine Associates and the author of Hormonal Balance.
Irene O’Shaughnessy, MD, is medical director at Froedtert & the Medical College of Wisconsin Endocrinology Clinic and co-medical director of the Diabetes Care Center.
Richard Shewbridge, MD, practices endocrinology at Cleveland Clinic’s Medina Hospital.
by Cindy Kuzma
For more information, please read my books Beat Overeating Now!: Take Control of Your Hunger Hormones to Lose Weight Fast and Hormonal Balance: How to Lose Weight by Understanding Your Hormones and Metabolism or visit my Facebook page.