Caring for Diabetes: Your HealthCare Team's Responsibilities

Dr. Fran Cogen Health Pro November 10, 2009
  • In my last blog, I discussed your responsibilities in regard to working with your healthcare provider(s). What are the healthcare team's responsibilities in regard to the care of your diabetes? What are the necessary requirements to ensure that you are getting the best care for you?

    1. Knowledge - just as it is important that you seek out the best healthcare team based on your information, it is essential that we stay up-to-date about the latest information pertaining to the care and treatment of your diabetes. We need to know the latest medications, side effects, and research that apply to you and your type of diabetes. If we do not know (and it is impossible to know everything) we should promise to find out by contacting a source that does know and then get back to you in a timely manner.
    2. Communication - your healthcare team must speak to you in a language you understand (literally and figuratively). If I were unable to explain how or why I would like you to change therapy or try something new, what would possibly motivate you to try? This mutual understanding takes time. Your healthcare team must try to ensure that you understand each other. Goals that were developed in conjunction with you and your team must be mutually understood with the intention that the person with diabetes will try to achieve them. And if there is difficulty achieving these goals, modification must occur through...
    3. Follow-up - you must be able to discuss the process and results of therapy with your healthcare team so that changes can be implemented. If we don't talk to you, how do we know what is going on?
    4. Providing appropriate treatment based on the needs of our patient, NOT based on the pharmaceutical industry's latest new drug. Matching the appropriate medication to the person with diabetes is essential. As I have mentioned before, "one size does not fit all" in terms of insulin regimes. We must base treatment on the current lifestyle of the child, teen, or adult.
    5. Cognizance of the cost of medications, supplies necessary to care for diabetes. Your team should be aware of the current financial realities and look to save costs as much as possible.
    6. The ordering of appropriate laboratory work applicable to the individual needs of the patient. Ordering a hb A1c every 3-4 months, yearly labs, etc.
    7. Continuing Medical Education to maintain a working knowledge of the current treatment modalities and evidence based research.
    8. Honesty - the importance of imparting information impartially and allowing the patient and family to make an informed decision in regard to treatment.
    9. A willingness to admit that the current treatment plan is not working or needs to be changed based on patient information or needs.
    10. Knowing when it is time to admit the healthcare team and patient relationship is not working, and then providing referral to another healthcare provider.

     

  • The Components of a Diabetes Toolkit for People with Diabetes

     

    1. Read appropriate information from trusted sources

    • a. Books written by experts in the field
    • b. Online sites that are reputable-do not believe reports that diabetes can be cured with a new herb, etc.
    • c. Mentors from acknowledged organizations: American Diabetes Association (ADA), Juvenile Diabetes Research Foundation (JDRF), Children with Diabetes

    2. Have a working knowledge of medications required to treat your form of diabetes (insulin, oral medications)

    3. Know the basic laboratory tests necessary for quality diabetes care. (hb A1c, lipid profile, renal function tests, thyroid tests, urine microalbumin/creatinine ratio, serum tissue transglutaminase for celiac disease, etc.)

    4. If you do not have access to an endocrinologist, find a general practitioner or internist who is willing to learn and access the appropriate information

    5. Be aware of related medical subspecialties that relate to diabetes care (podiatry, nephrologist, gastroenterologist, ophthalmologist, neurologist, psychiatrist, etc.)

    6. Learn about nutritional options: portion control, carbohydrate counting, low carbohydrate diet, etc.

    7. If you care for a child/teen with diabetes, learn about the 504 plan (Americans with Disabilities Act).

    8. Be aware of the insurance options available to you (Medicaid, Medicare)

    9. Learn about cost-savings options (meters, strips, etc.) from others (such as other MyDiabetesCentral bloggers).

    10. Work with a healthcare professional and treat as an ally, so that you can reach your goals together. Don't go it alone