Diabetes – C is for Consultations

For those readers of my webpage who have been following these articles in sequence, today concludes the series on what might be termed the Eightfold Technique of Managing Diabetes.

The final letter C in the word DIABETIC stands for Consultation – which ties all the others together. I often tell patients who have been diagnosed as diabetic, have acquired an understanding of the condition, taken steps to get the situation under control and have stabilised their blood glucose readings and blood pressure measurements, with or without medication, that this is just the beginning of a long and lasting relationship with Diabetes.

Unlike conditions such as appendicitis or kidney stones, where diagnosis followed by definitive treatment, chronic conditions like diabetes need regular monitoring over the long term. As time goes on, people with diabetes often require modifications to their treatment regime to keep the disease under control.

This is why every diabetic needs a good team of health professionals they can consult on a regular basis to help them with managing this disease. Obviously the team must include a doctor – either a committed general practitioner or a specialist, who can check blood test results, measure things like weight, waist and blood pressure, assess the circulatory and nervous systems as well as organs like the heart, kidneys and eyes that can be affected by diabetes.

My personal opinion is that a diabetic needs a good GP who can check them twice or three times a year and advise about modifying if necessary the medications they are taking – with this GP working in collaboration with a good diabetes specialist who can see the patient for a specialised check-up once a year.

Many people make the mistake of thinking that only a specialist consultant physician (a doctor who has specialised and has postgraduate qualifications in medicine) can manage diabetes.

If you have diabetes it is certainly more cost effective for basic diabetes management to find yourself a good GP (Family Physician) who will from time to time refer you to consult an Endocrinologist (a specialist physician who has an interest and training in hormonal diseases like diabetes) to get expert assistance with your management. This is because the specialist will be au fait with new techniques and medications (for example, modern drugs like Sitaglyptin and Exanetide which I have mentioned earlier) and can help to fine tune management.

Other health professionals you may need to consult are dietitians (who can assess and advise about your diet), diabetes educators – and if available specialised professionals called exercise physiologists (who can advise about exercises, particularly if you have conditions like arthritis or plantar fasciitis that preclude you undertaking the usual forms of exercise) and podiatrists (who can help with care of your feet and nails).

An analogy I often use is that a cricketer can have the best coach, physiotherapist, masseur and manager in the world – but how he performs when he is out in the middle is entirely up to him. Obviously, trying to perform without a coach and support staff is foolish – but whoever your coach is makes not a jot or tittle of difference when the eyes of spectators are on you and you take your stance at the wicket to bat.

So while managing your diabetes is up to you, select yourself a good team – GP, specialist and ancillary health care professionals. Consult them regularly and follow their advice.

The rest, as they say, is up to you.