emotional health

The Captain of Your Diabetes Team

Diabetes affects so many aspects of one’s life…

As a result, no one health care provider can know and do everything you need to successfully manage it for you.

It truly takes a team to manage diabetes effectively by developing and sticking with a diabetes self-management plan.

As the person living with diabetes, it’s up to you to assemble your team and act as its captain.

The Team Members

•  A primary care provider is often responsible for advising you about the medications best suited for your diabetes, and preventing short- and long-term complications.

•  A nurse educator helps with learning many of the self-management skills, such as blood glucose monitoring, foot care, identifying and treating a low blood glucose reaction, making behavioural changes and how to cope with stress of living with diabetes.

•  A dietician is also a key member of a diabetes care team because diabetes self-management almost always involves learning about meal planning. For most people, the goal is to keep blood glucose and blood pressure levels as close to normal as possible. Because food affects your blood glucose levels, the role of the dietician is very important in helping you manage your diabetes.

•  Your team may also include someone to help you cope with and manage the emotional aspects of living with a chronic illness.

•  Unless your diabetes is treated with diet and exercise alone, another person that you will need to interact with frequently is a pharmacist. Prescription medications and supplies, such as blood glucose meters and strips, are usually obtained through a pharmacy. Your Walgreens pharmacist understands diabetes and the impact that various medications may have on you and your health. For example, you might be taking a medication for another illness that could cause your blood glucose to rise or fall. Your Walgreens pharmacist will be on the lookout for combinations of medications that may pose a problem for you.

However, the most important member of the care team is you. You are responsible for providing more than 95 percent of your own diabetes care. What’s more, you are the one who benefits from good care and the one who pays the price for poor care. The role of the other team members is to guide, assist and support you in carrying out your self-management plan. But it is in your best interest to be the captain of your diabetes care team.

Various Team Structures

In order for your self-management plan to work, all of its elements must fit together with one another.

This includes what you are willing and able to do to manage your diabetes on a daily basis. In some cases, diabetes care teams work for the same health care organization and meet on a regular basis to discuss individual patients and coordinate care. But, in today’s health care environment, this kind of team care is becoming increasingly rare.

Even if all of your team members work at the same facility, they may not meet together to discuss your care.

This means that your role as team captain is essential for making the teamwork. You may be the only person who interacts with all of the different team members on a regular basis. So it is up to you to make sure that the advice you receive from different providers fits together to make a self-management plan that is realistic and helps you achieve your diabetes care goals.

More often than not, your diabetes care team members will work for different institutions. For example, you may receive your medical care from a primary care provider at one clinic and get some of your diabetes education from group classes taught by a nurse and dietician at a local hospital. Individual counselling might come from a different community-based dietician.

When the team members are spread out, your role becomes increasingly important because your team members probably don't communicate with each other all that often. They may not even share the same overall approach to diabetes care.

Another possibility is that you may only have access to a primary care provider and a nurse educator, but not to a dietician. Or, you may have access to a primary care provider and a dietician, but not to a nurse educator. Again, this presents a challenge for you because input from all three—the primary care provider, nurse educator and dietician—is crucial for developing and carrying out an effective diabetes care plan. When all of the team members are not available, you need to find some of the missing information on your own. For example, let’s assume that you do not have access to a dietician. Although you probably could get some nutrition advice from other team members, it would be in your best interest to learn about nutrition yourself in order to ensure that you are following the best meal plan for you.

More Information

The American Diabetes Association (ADA) is an excellent resource for learning more about the various aspects of diabetes care. You can visit their web site at www.diabetes.org or call them at 1-800-DIABETES (1-800- 342-2383). The ADA can provide some of the information that you would normally obtain from a diabetes care team member.

Another way to learn more is to join a local chapter of the ADA or a local support group for people with diabetes, if such groups are available in your area. But the information that you receive from other people with diabetes or even on the Internet may not be correct. It is very important that you check out any tips or diabetes care advice that you have received with your health provider before trying it out. Though there may be some rough patches along the way, empowering yourself with knowledge and being committed to making your diabetes care team work will lead to smooth sailing ahead.

Bob Anderson
EdD 2004
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