Living with Type 2 Diabetes? Be Sure to Add These Specialists to Your Health-Care Team

By Jane Farrell

Diabetes is a complicated condition. It doesn’t just affect your blood glucose level and insulin sensitivity; it affects every part of your body, from your mind to your stomach to your toes. And to stay as healthy as possible, you need to keep all those important parts in good working order. For that reason, people with type 2 diabetes don’t just “go to the doctor.” They go to a team of healthcare professionals—and for people who are newly diagnosed, this can feel a little overwhelming.

Luckily, you don’t have to worry about assembling your healthcare team all at once. At first, you may need to see only your diabetes care provider and a certified diabetes educator. They could be all you need for a long time, or forever. But according to the American Diabetes Association’s new book Managing Type 2 Diabetes For Dummies®, it’s a good idea to learn about the other experts in diabetes care now. That way, you will be prepared should you ever need to visit one of them in the future.

Here, from the American Diabetes Association’s Matt Petersen, is a list of the key healthcare team members for managing type 2 diabetes.

Start off with a diabetes care provider… This is your go-to person who helps you manage your condition. Your diabetes care provider might be your primary care provider, a family practitioner, internist, or nurse practitioner. A diabetes care provider will give you a yearly physical exam and an A1C test every 3-6 months to make sure you are staying healthy.

…and a certified diabetes educator. A certified diabetes educator (CDE) is the other key player on your healthcare team. When you are first diagnosed with diabetes, your provider will likely refer you to a certified diabetes educator or a diabetes class taught by one. They are experts at handling your diabetes education and answering your questions, and make managing your diabetes easier in your everyday life. A CDE can help you develop a plan to eat healthful foods, get physically active, and take your medications.

See an endocrinologist to keep hormones in balance. An endocrinologist is a physician trained to treat people with hormone imbalances, including diabetes. You may find this training and expertise helpful in managing your diabetes. Don’t worry that you’ll have to say goodbye to your primary care provider if you choose to see an endocrinologist—you can see them both!

Make better food choices with a dietitian. They are experts in food and nutrition, and are your best bet for getting the latest info on healthy eating. They can help you reach your health goals like losing weight, reducing sodium, or cutting back on sugar. You may see a dietitian when you’re first diagnosed with diabetes and then for yearly visits afterward.

Remember, when you have type 2 diabetes, what you eat is critical to your health. A dietitian is a great person to bounce ideas around with when you’re having trouble reaching your blood glucose targets. You can also work with your dietitian to create a plan that you will be able to maintain, by incorporating foods that you enjoy and that are a part of your culture and traditions. They’re also great for helping you find healthy substitutes for pleasurable but unhealthy foods like pizza or popcorn.

Keep your eyes in check with an ophthalmologist or optometrist. When you have diabetes, your eyes are particularly vulnerable to vision changes and damage because the blood vessels in your eyes can rupture and swell over time. This is why an eye specialist such as an ophthalmologist or optometrist should be part of your healthcare team.

An ophthalmologist is a doctor of medicine (MD) who specializes in eye care and eye diseases; an optometrist is an eye doctor with a doctor of optometry degree (OD) who diagnoses vision changes and disease, and does sight testing and correction. When you are first diagnosed with diabetes, it’s important to have a comprehensive, dilated eye exam by an ophthalmologist or optometrist. After that, you should get an exam every 1-2 years, depending on your sight and diabetes care.

Luckily, you can prevent or delay blindness caused by diabetic retinopathy with early detection and treatment. An eye specialist can diagnose damage in your eyes even though you may not notice any vision problems on your own. Don’t wait until you notice vision changes to get checked out.

Have a pharmacist fill you in on medication details. If you have diabetes, you’re probably not just taking one medication, but perhaps a pill for blood glucose, a pill for high blood pressure, and maybe even another pill for cholesterol. The interaction of these medications can impact your body. This is why your pharmacist should be a key member of your healthcare team. They are experts on medications, including dosage, uses, and how the drugs interact.

Your pharmacist can tell you how often and how much medicine to take and its potential side effects. They can also tell you how new prescriptions will affect your current medication. And if you have trouble keeping track of your medication, ask your pharmacist for help. They may be able to offer specific tips or tools for taking medications daily.

Keep your mouth in tip-top shape with a dentist and dental hygienist. Good oral care is a top priority for people with diabetes, because they may be more susceptible to mouth and gum infections caused by elevated blood glucose. The best way to prevent these infections is to brush twice a day and floss. The other way (which is equally important) is to visit a dentist every 6 months for a teeth cleaning.

Be sure to tell your dentist that you have diabetes and make sure you include it on your paperwork when you check in. And make sure your dentist or hygienist know about any problems you’re having, like dry mouth, bleeding or sensitive gums, or persistent bad breath or bad taste in your mouth.

Focus on fitness with an exercise physiologist. Exercise physiologists are health professionals who help you develop a fitness program. They work directly with you to assess your current health and come up with an exercise plan that fits your goals.

If you have certain diabetes-related complications like heart or lung problems, your diabetes care provider may refer you to an exercise physiologist for a stress or fitness test to evaluate your health, pinpoint concerns, and develop a personalized plan for exercise.

Get back on your feet with a podiatrist. People with diabetes often have poor circulation to their feet and nerve damage, which makes it difficult to feel cuts and sores. This is why a podiatrist—a doctor with specialized training to care for and treat foot problems—is a key part of your healthcare team. They take care of corns, calluses, and foot sores to prevent more serious infections. A podiatrist can show you how to correctly trim your toenails, take care of your feet daily, and can prescribe and fit you for specialized shoes to make walking and exercising more comfortable.

An important word of advice: Don’t ever ignore or try to treat foot problems on your own. Call your diabetes care provider or your podiatrist if you have changes in feeling such as pain, tingling, numbness, or burning, a puncture wound from stepping on a nail or a thorn, an ulcer, a cut or sore that won’t heal, an infection in a cut or blister, or a red, tender toe.

See a dermatologist for healthy skin. People with diabetes may have problems with their skin, because high blood glucose can cause dehydration, and dry or moist skin can cause infections. If you have skin problems, a dermatologist can tell you how to better care for your skin to prevent dryness and infections, as well as prescribe medications to treat these issues.

Visit a mental health specialist to keep your thoughts and emotions in check. Your mind and emotions are just as important as your physical health—in fact, the two are closely entwined. Living with a chronic condition such as diabetes can be exhausting and annoying. It can even lead to conditions such as diabetes burnout, depression, and anxiety. Mental health specialists are trained to help you cope with these sometimes overwhelming thoughts and emotions. There are a wide range of specialists available to meet your needs, including psychiatrists, clinical psychologists, marriage or family therapists, and social workers. Ask your diabetes care provider for a referral or recommendation for a mental health professional.

Keep your kidneys in working order with a nephrologist. People suffering from diabetes are more likely to have problems with their kidneys, because high blood glucose can damage blood vessels in these organs. Your diabetes care provider may recommend you see a kidney doctor, called a nephrologist, to help you keep your kidneys healthy.

The best thing about building your healthcare team is that it’s a reminder that you’re not facing diabetes alone. These experts will guide you every step of the way, and give you the confidence and wisdom to make smart decisions that will keep you healthier longer.

Matt Petersen has been with the American Diabetes Association since 1993, first as managing editor of the Association’s professional publications, and then as director of the Association’s Research Program. Since 2001 he has directed the Association’s Medical Information and Professional Engagement Department, which oversees the Association’s messages about diabetes (diabetes treatment and management information, statistics, etc.) for the general public. The department is also charged with improving and expanding the ways in which the Association provides services to its professional members and other healthcare professionals.