There is no doubt that living with diabetes on a day to day level is challenging. All the decisions that you have to make everyday, that will have a bearing on your diabetes control and that amount of responsibility can be overwhelming. Because you care for your diabetes on a daily basis, you are an expert in your own care and you are the most important person in your diabetes team. So having the support from an understanding health care provider is paramount. To achieve the best possible diabetes care, you need to work together as an equal member of your team.
So who are your Diabetes Team?
- Practice Nurse
- Diabetes Nurse Specialist
- Gym/Personal Trainer
Not all of the above professionals will be permanent members of your team, your GP practice will be your primary care providers and the one service you will probably have the most contact with. They will refer you to other members of your team, depending on your needs and progression of your diabetes. Not all people with diabetes will be or need to attend a hospital based service especially those with Type 2 Diabetes.
You need to understand your diabetes as well as possible in order for you to be an effective member of this team. The following is a guideline to help you to achieve the most from your visits to your healthcare providers:
I am always encourged by people when they attend for an appointment at Diabetes Insight to see a list of questions being produced, medications list, a recent set of blood results and a medical history. This tells me straight away that this person is actively engaged in their health care and we are off to a good start!
Always having a list of questions that you want answered means you will get the maximum benefit out of your appointments. You will leave fully satisfied knowing that was has been asked and answered what is important to you. Keep a little notebook with you at all times that you can write down questions as you think of them on a day to day basis and bring it to your next appointment for those questions to be answered by your health care provider.
Be Patient with Yourself & Ask For Understanding!
Everybody learns in different ways and having to learn new habits and information will take some people more time then others. It is estimated that a person who is newly diagnosed with diabetes takes eighteen months after their diagnosis to come to terms and become comfortable with their diagnosis. So give yourself some time and be patient and ask it of others as well, even your health care professional, as they may not be aware of your difficulties and can change their educational approach to suit your learning style.
Find a Diabetes Team/Health Care Professional that suits your needs!
This may sound easier said than done, as for many people especially in Ireland, are very reluctant to move from one health care professional to another. Remember you have diabetes for life, and building up a supportive, trusted relationship with a health care professional who is highly skilled, up to date and motivates you with your condition is imperative to your long term diabetes control. Also having access to a service that is available to you when you require it and facilitates your needs is also very important. Always share whatever concerns you have with your current health care professional,as they may not be aware of your issues, and may provide you with additional options.
Get Help From Your Peers!
Seek out those who are also in a similar situation to you, through support groups and charity organisations such as Diabetes Ireland www.diabetes.ie or www.mydiabetes.ie. Diabetes Insight also runs a social group on a monthly basis from Blackrock Hall Primary Care Centre, Cork, or can put you in contact with a number of people with diabetes both Type 1 & Type 2, who would be very willing to speak to you via telephone on a private one to one basis if you are struggling with your diabetes. Be very careful who you speak to amongst the general public about your diabetes. Many people are misinformed about diabetes and may provide you with information that is not entirely accurate. Most people are only trying to be helpful, but we all have come accross the one eager person who is dying to tell you about their aunt who had diabetes and ‘she went blind, had gangrene and her kidneys failed all from diabetes, terrible disease, she died from it’!!!!!!! This is not exactly the kind of information you want to hear when you are diagnosed! An excellent website www.behavioraldiabetes.org provides very useful information to help inform and educate your family and friends on how to be helpful and encourgaing when managing your diabetes
Always Clarify the Infomation that you have Been Given
This may sound like a very simple statement, but many people find the information given at an appointment with their diabetes nurse/other health care professionals overwhelming and confusing. By asking questions it helps the nurse/doctor etc, realise the areas that are causing you the greatest difficulties. Do not be afraid to ask for information in writing for you to take home and read, ask for reading lists or websites that you can access information for yourself. Some of the questions that you should ask at your appointments are as follows:
- What are the blood tests for?
- When will I have the results?
- Are there other ways to treat my condition?
- What are my medications for?
- Are there any side effects from these medications?
- How do I know my treatment is effective?
- What can I be doing to help myself?
- When do I come back to see you?
- Who do I contact between these visits if I need to?
Do not be embarrassed to share personal information that causes you embarrassment such as erectile dysfunction in men,as this can be a sign that other problems are occuring in your body. Ask for more information and explainations if something is not clear.
Bring a Family Member/Friend with you!
It can be very useful to bring someone along to your appointments not only for support, but also to take in the information that you may have missed. Also, especially with family members, they learn with you, can ask questions and allay their own concerns, and in doing so, are less likely to nag you about your condition and lifestyle changes they have to make.
Ask & Know Your Blood Test Results!
It amazes me how many people can be attending their doctor for years and not know what their blood results are such as cholesterol, HbA1c and blood pressure. It is my opinion and that of many health experts out there, that every single person with diabetes, should know these results and what they stand for. Know your targets also, as well as what medication you are taking. It is not good enough to attend a doctor and say I take a blue tablet in the morning and a pink one with my lunch. If you cannot remember, write them down on a card and carry it with you in your wallet/purse/handbag along with your most recent results. Most clinics have little wallet size cards and can help you with this. We have a culture in Ireland of handing our illness/ sickness across to a GP/healthcare professional and expecting to be treated instantly. In diabetes this is not the case, as the responsibility for looking after the condition falls equally on both you and your diabetes team.
Your healthcare team should always treat you with respect and dignity, skill and care, keep you up to date on your diabetes and regularly review your medical & psychological needs.
There is a minimum level of care that all people with diabetes has a right to, deserves and should expect:
- Have your Hba1c levels checked at least once a year
- Have your blood pressure recorded on each visit to your GP/nurse
- Have your fasting cholesterol checked at least once a year
- Have your eyes screened once a year by a specialist, who will conduct a dilated retinal eye exam
- Ensure your legs and feet are checked annually by GP/nurse/podiatrist using a monofilament and tuning fork
- Have a blood test to ensure your kidneys and liver are functioning well annually, as well as a urine test for protein
- Have your flu/vaccinations shots every year
- Have your weight checked on each visit
- Have a dental exam every 6 months
- If you smoke, seek help and support to quit
- Discuss any issues of sexual health that you may have
- Know your diabetes targets and negotiate your plan of care
So what are your responsibilities?
- To take as much control of your diabetes on a day to day basis as you can
- To learn about and practice self care which should include, dietary education, exercise and monitoring blood glucose levels
- To examine your feet regularly or to have someone check on them
- Know how to manage your diabetes and to ask for help when you need it especially when you are ill
- To build the advice you have been given into every part of your daily life
- Attend your appointments and inform your team if you are unable to do so
- List your questions, talk regularly to your team
Knowing that you are meeting your responsibilities means that you are getting the most from your appointments. At Diabetes Insight, we can provide you with all the above services but also help you to gain the most from your existing diabetes services.