Choosing the Best Health Care Team for Diabetes Management

If you've recently been diagnosed with diabetes, you may be feeling a little overwhelmed at the sheer number of specialists you're suddenly supposed to visit. Besides your primary care physician, you may be told to see an endocrinologist, a certified diabetes educator, a registered dietitian, a podiatrist and an ophthalmologist.  You may be wondering how best to choose a health care team,  and whether or not you should make an effort to ensure that they're all in the same medical facility, for convenience' sake.

"First off, realize that it's important to be pro-active about your care and to be a vital part of your health care team, "says Zippora Karz, former solo ballerina, LA-based diabetes spokesperson and educator, and author of The Sugarless Plum.

"You want a doctor you can communicate with," Karz says. "In the beginning, when you are first diagnosed, there are so many emotions, such as shock, anger and denial. You need a doctor who will talk with you, take the time and make you feel comfortable."

Also, she says, it's important to find a health care provider who will work with you to find the best protocol for you. "If you are having problems, you want to be able to say, this didn't work for me. What can I do to fix it?" Karz says.

One common mistake patients make is to assume that their doctor will take care of everything. "You need to be the captain of the team and put together a group of doctors," says Tracy L. Breen, MD, clinical director of the Mount Sinai Diabetes Center in New York City. "You need to get copies of your medical records and take them with you when you visit the doctor. These days, with insurance plans changing so much, people need to get more proactive about keeping all their own medical information together." Instead of waiting until you get to a particular doctor's office and then calling the other doctor's office to request that they fax over your records, always take your own.

According to Stuart Weiss, MD, clinical associate professor in the Department of Medicine at NYU Langone Medical Center in New York City, "an estimated 90 percent of people with diabetes are cared for by a primary care physician, rather than an endocrinologist."  

"Sometimes at a doctor's visit, not enough time is devoted to discussing diet, exercise or issues with the feet," he says. "Any issue with the feet, even if it is just a blister, should send to you the podiatrist. When the blood sugar is elevated, the ability for white blood cells to fight the infection is diminished."

Breen suggests that even if you don't require a team of doctors on a regular basis, there are certain regular tests that you should plan on having.  

A person with diabetes should have the kidneys screened annually, through blood and urine tests, she says. She should also have a hemoglobin A1C several times a year, and an annual blood test to check the cholesterol. Your doctor also should monitor your blood pressure.

"You want to keep blood pressure under 130/85. If it's not there, you'll want to work with your doctor on this."