How you can build the world’s greatest diabetes care team

Anyone who plays sports knows that assembling the right team can be the difference between winning and losing. Managing your diabetes is no different. Whether you were diagnosed a few days ago or many years ago, diabetes is a complicated disease that requires constant attention and major lifestyle changes. You need to rally the right team of health professionals to help support your efforts to control your blood glucose levels.

Key members of your team should include:You!
You are the person who is experiencing the disease and who knows best what you are able to do to manage it. Your team depends on you to report any problems and talk honestly about how you feel. “The patient is quarterback of the team—the person who has to do 99% of the work,” says John Buse, MD, president of medicine and science for the American Diabetes Association (ADA). “Everybody else provides advice, teaches skills you need, helps you stay on track, makes assessments you can’t make, and watches for complications.”

Primary care physician
Regardless of how many specialists you may see, you still need a primary care doctor to coordinate your overall health care and make sure you get routine tests. You should feel free to ask your physician if he has any special training in diabetes and how many of his patients have diabetes.

If you worry about not making sufficient progress in controlling your blood sugar, you may want to consult an endocrinologist, a physician who specializes in treating people with diabetes. The endocrinologist is not a substitute for a primary care physician, however.

Certified diabetes educator (CDE)
Usually a nurse, dietitian, or pharmacist specially trained to educate people with diabetes, a CDE will teach you how to cope with diabetes on a daily basis. You’ll learn how to use diabetes medications and give yourself insulin shots, if needed, and how to check and keep track of blood sugar levels. The diabetes educator may also help devise an exercise program.

Registered dietitian
Often, your diabetes educator is also a trained dietitian. If not, you need to see a dietitian separately to help plan a diet based on your personal needs. He or she will explain how foods affect your blood sugar and blood fat levels and teach you how to read food labels, plan meals, and balance meals with medication and exercise schedules.

Eye doctor
Because diabetes can affect the blood vessels in the eyes, you should schedule a yearly checkup with an ophthalmologist. Always report any changes in your vision.

Dentist
While the dentist is not technically a member of your diabetes care team, it is crucial to keep regular dental appointments, because people with diabetes have two to three times greater risk of gum disease. Poor dental health may also hurt your heart.

Depending on your specific needs, other members of your healthcare team might include:

Podiatrist (a foot doctor)
Because diabetes can disrupt blood flow in the lower legs, some patients get frequent foot infections. Inspect your feet regularly, and have any foot sores or calluses checked by a podiatrist. Even small sores can quickly turn serious.

Social worker/psychologist/psychiatrist/family therapist
Depression and other mental problems are more common in people with diabetes. A trained therapist can provide counseling to help you cope with family, marital, or job problems related to your diabetes. A psychiatrist is a medical doctor who can also prescribe medications for depression and anxiety.

Cardiologist, kidney specialist
These specialists will become part of your team if you develop cardiovascular or kidney complications, which unfortunately are common among people with diabetes.

Not sure where to start? Your primary care physician can refer you to a diabetes educator and can help you build the rest of your team. Or at a diabetes clinic you will find most members of a team under one roof or nearby. For further information, consult the ADA at www.diabetes.org, which can refer you to local diabetes education programs. Or go to the American Association of Diabetes Educators site, www.diabeteseducator.org, which can put you in touch with certified educators in your area.

Finally, don’t forget the importance of asking your famiy and friends to help support your efforts.