Diabetes is a rather complex illness for patients and providers to manage and for that reason people with diabetes need to be cared for by a team of professionals. I like to refer to this as someone’s Diabetes Care Team. Just image yourself in a room with ten other people. In the center of the room hangs a globe of the earth. Look at the globe. What one person sees is different from what the person sitting on the opposite side of the room sees. Those persons sitting in the corners of the room also see something unique and different. Assembling a diabetes care team is no different. Each health-care professional sees you (the globe) from a different part of the room, or from a different perspective, so they each see something different when looking at you, the patient.
The take-home message here is to be sure that your globe, or your entire person, is being looked at and taken care of from all sides, or perspectives.
To accomplish this you need to assemble a team of health-care professionals who will care for you, as well as educate you, on caring for your diabetes. Keeping these thoughts in mind, let’s move forward and learn who the key players are, as well as some supporting team members, whom you may or may not need at the moment, but may need on your team at some point in time.
YOU
You are the owner of your diabetes care team, and as the team owner, you are the most important person. Your team cannot be successful if you are not 100% committed. The team I will help you assemble can make all the correct recommendations and treatment decisions, but if you are not dedicated, then the team, and therefore you, cannot succeed. You have a number of responsibilities, which include the following.
- Following your diet
- Exercising regularly
- Monitoring your glucoses at home
- Taking your medication properly
- Attending support group meetings
- Assembling your care team
- Following the various treatment recommendations from your care team
I often tell patients, “My nurses, the dietitian and I are willing and able to help you get your diabetes under control, but if you are not committed, we cannot succeed.”
PRIMARY CARE PROVIDER
Every team needs a leader, or captain if you will. Choosing your captain is a crucial step in the success of your team. This person will be your leader, your anchor, and possibly the person who introduces you to the remainder of your team roster. Your captain can be a physician, a nurse practitioner, or a physician’s assistant.
CERTIFIED DIABETES EDUCATORS
Your care team also needs certified diabetes educators. These are individuals who have passed an examination after at least 2 years and 1000 hours of providing diabetes self-management education, and have subsequently received certification by the National Board of Certified Diabetes Educators. This certification is for those professionals who provide excellent education regarding diabetes self-management. You should find both a nurse and a dietitian who possess this certification. These individuals can be found at an American Diabetes Association (ADA)-recognized Diabetes Education Center. Persons who go to these diabetes education centers for information typically receive both individualized teaching with a nurse and a dietitian, and attend group classes pertaining to a number of diabetes-related topics.
DENTIST
Regular dental exams are recommended for all people with diabetes. Therefore, a dentist who is aware of your diagnosis and who is willing to work with your diabetes care team is necessary.
EYE DOCTOR
You will need an optometrist or an ophthalmologist for your eye exams. Again, look for someone you feel comfortable with, who knows your diagnosis, and who specifically performs diabetic eye exams. Some providers can take photographs of the back of your eyes (the retina), which can be stored and compared year after year in order to identify any changes.
PHARMACIST
You also need a pharmacist. Look for one who makes you feel comfortable and with whom you can talk and discuss issues pertaining to your needs, as well as any questions you have about your medications. It is also highly recommended that you use only one pharmacy, to decrease the likelihood of medication errors and interactions. In addition, look for a pharmacist who can provide durable medical equipment such as testing supplies, testing strips, insulin syringes, needles for your insulin pens, and diabetic shoes.
These are the key players on your team. These are the people that every team requires to provide optimal diabetes management. Your primary care provider (or captain) is a reliable source to recommend other team members.
I cannot emphasize enough how important it is for you to take the time and effort to choose the correct person to lead your team and be sure that you, the team owner, are committed to the team’s success, and prepared for the hard work and behavioral changes needed to be successful.
Finally, there are additional health-care providers you may require on your diabetes care team at some point in the disease management process. These providers are chosen based upon your individual treatment and related conditions.
