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Monitoring & Treatment » Your Healthcare Team » Healthcare Professionals

While you are the most important member of your healthcare team, you may also add different people - diabetes educators, ophthalmologists, podiatrists - who take part in your diabetes care. Use the links to the left to find out who should be on your healthcare team and how you can maximize the time you have with them.

Why Do I Need A Healthcare Team?

If your home computer crashed, would you ask a handyman to fix it? No. You'd take it to someone who specializes in repairing computers. And if you wanted help landscaping your yard, you'd probably hire a landscape architect. The same is true with treating diabetes. Your doctor is your main resource for treating your diabetes, but he or she isn't an expert in all the day-to-day challenges of living with diabetes. That's why a team approach is critical.

Who Is On My Healthcare Team?

The core members of your healthcare team should include:

•   you
•   your doctor (primary care physician and/or endocrinologist)
•   certified diabetes educator (CDE)
•   registered dietitian (RD)

Finding Your Team

Your doctor should work closely with you to manage your diabetes. He or she may put together the team you need or recommend healthcare professionals for you to see. If this doesn't occur, it would benefit you to talk openly with your doctor about putting a team together to help manage all aspects of your diabetes. For your own education, you may want to look for a diabetes-education program that offers individual or group classes. The American Diabetes Association has a list of "recognized" diabetes programs, and there may be one in your area. Call (800) DIABETES for this information. You may also call your local hospital and ask about a diabetes education program or diabetes educators on staff. Or call the AADE Diabetes Educator Access Line at (800) 832-6874.
By relying on an entire team of healthcare professionals, you are ensuring the best care for your diabetes. More help is better!

Endocrinologist

An endocrinologist treats people who have problems with their endocrine glands. Diabetes is an endocrine disorder. You'll probably rely most on an endocrinologist or a primary care physician to help you manage your diabetes. Think of this person as the hub of a wheel, with other specialists serving as the different spokes.

Certified diabetes educator (CDE)

Another critical member of your team, a CDE is a healthcare professional who is qualified by the American Association of Diabetes Educators to teach people how to manage their diabetes. He or she may be a registered nurse, a registered dietitian, a pharmacist, physician, etc. A CDE is your in-depth diabetes source, trained to help you with the day-to-day challenges of living with diabetes. You can find a CDE in your area by calling the American Association of Diabetes Educators (AADE) Diabetes Educator Access Line at (800) 832-6874 or by accessing their online search tool.

Registered dietitian

A dietitian is an expert in nutrition who helps people with specific health needs plan the kinds and amounts of foods to eat. A registered dietitian (RD) has special additional qualifications. Since diet is such an important part of managing diabetes, you can truly benefit from working with a dietitian. An RD can help you by assessing your current diet and tailoring an eating plan that will bring your blood sugar levels as close to normal as possible.

Cardiologist

A cardiologist is a heart specialist. Heart disease is a common and very serious complication of diabetes, because extra glucose can clog the coronary arteries. A cardiologist can help you reduce or alleviate the risk of heart disease through treatment or medication. Your doctor may recommend a visit to a cardiologist if a medical exam shows potential artery blockage. Or, if you have concerns about your own risk for heart disease, talk to your doctor to see if a visit to a cardiologist makes sense.

Gastroenterologist

A gastroenterologist sees and treats people with stomach and intestinal problems. Diabetes can damage the nerves of the digestive tract, causing gastrointestinal problems. It can also cause problems with the esophagus (the tube that carries food from the throat to the stomach). Esophageal problems affect about 75% of people who have had diabetes for many years. Heartburn is a common symptom. Another stomach/intestinal problem is called gastroparesis, which occurs when the stomach's muscles weaken, and it loses the ability to push food into the intestine. About 25% of people with diabetes have some gastroparesis. Symptoms include nausea, vomiting up partially digested food that has been sitting in the stomach, dry heaves, abdominal bloating, abdominal pain, and loss of appetite. A gastroenterologist can help treat these problems. If you have any of the symptoms listed above, talk to your doctor about seeing a gastroenterologist.

Nephrologist

A nephrologist sees and treats people with kidney diseases. Twenty to 30% of people with type 1 or 2 diabetes develop kidney complications within 15 years of diagnosis. When diagnosed, it is called diabetic nephropathy, and it occurs when small amounts of protein in the urine are detected (known as microalbuminuria). People with diabetes should have their urine checked yearly for protein. Symptoms of advanced nephropathy include fatigue, insomnia, weakness, vomiting, and swelling around the body from fluid build-up (edema). If you do develop kidney disease, a nephrologist will handle your treatment.

Neurologist

A neurologist sees and treats people with problems of the nervous system. As your average blood sugar level increases, so does risk of neuropathy (nervous system disorder). Neuropathy doesn't affect the brain or spinal nerves, but it can damage the rest of the nervous system. Symptoms may include a loss of bowel or bladder control, problems with digestion, muscle weakness, impotence, pain, a pins-and-needles feeling in the hands or feet, or a loss of pain sensation in the extremities. A neurologist can determine whether you have developed neuropathy, and if so, what treatment is necessary.

Obstetrician/Gynecologist

An obstetrician/gynecologist (OB/GYN) sees and cares for women during pregnancy, delivers babies, and treats the gynecological health of women. Women with diabetes usually have healthy pregnancies and give birth to healthy babies, but it takes some effort to make this happen. When you do decide to start a family, meet with your team to consider the specific challenges ahead for you and your baby.
Women without diabetes can develop gestational diabetes during pregnancy. Hormones released during pregnancy can raise the mother's blood sugar levels to diabetic levels. The mother can lower levels with diet and exercise, or she may need to inject insulin. Gestational diabetes disappears after giving birth, but women who have had it are at risk for developing type 2 diabetes later in life. Women are tested for gestational diabetes around the 26th-28th week of pregnancy.
If you have diabetes or develop gestational diabetes, your OB/GYN can help you manage your condition to ensure the healthiest pregnancy and healthiest baby possible.

Ophthalmologist

An ophthalmologist sees and treats people with eye problems or diseases. Vision impairment -- including blindness -- is a frequent chronic complication of diabetes. People with diabetes are four times more likely to become blind than those without diabetes. The disease that causes vision problems or blindness is called retinopathy. As average blood sugar levels rise, so does risk of retinopathy. An ophthalmologist can use laser surgery to treat retinopathy.
Diabetes also increases the risk of cataracts, caused by clouding of the lens of the eye, and glaucoma, caused by an increase in fluid pressure within the eye that damages the optic nerve. These conditions cause much of the vision impairment in type 2s over age 30. By having an annual eye exam, an ophthalmologist can track your vision from year to year and catch eye disease in its earliest stages, when treatment is easier and more effective.

Periodontist

A periodontist specializes in treating gum disease. Gum disease can develop as a complication of diabetes and can lead to tooth loss. See your dentist at least twice a year. If he or she diagnoses gum disease, a periodontist can determine the best method of treatment.

Pharmacist

A pharmacist is trained to prepare and distribute medicines and to give information about them. Your pharmacist is a good source of information about any diabetes-related medications you're taking. Medication and what it does can be complicated. Your pharmacist can tell you about side effects and potential drug interactions. He or she can also recommend meters and strips for you to use. If your pharmacist doesn't know the answers to your questions, he or she will tell you which healthcare professional to consult.

Podiatrist

A podiatrist treats feet. People with diabetes who have nerve damage are especially prone to foot infections. To prevent foot infections, examine your feet regularly at home. And every time you see your physician, ask for a foot examination. If you develop a foot infection, a podiatrist will provide the best treatment possible.

Psychologist

A psychologist specializes in people's emotions and behaviors. You may need to see a psychologist if you become depressed. Depression is a common and potentially dangerous side effect of diabetes. It can interfere with disease management and lead to many physical, mental, and emotional complications. But depression is treatable. If you learn to recognize its danger signs and know how to seek treatment, depression can be controlled. The best results frequently come from the combination of antidepressant drugs and psychotherapy.

Urologist

A urologist sees men and women for treatment of the urinary tract and men for treatment of the genital organs and impotence. People with diabetes are at increased risk for all types of infections, including the bladder and the kidney. Your physician may detect an infection during an exam and may recommend that you see a urologist. If you suspect you have a urinary tract infection of some type, talk with your doctor promptly.

Last modified: October 08, 2008