Your Doctor and Healthcare Team

Appointments with your doctor are very important. But, you must take Doctor and Patient an active role in the appointments. Do not blindly accept drugs from your doctor as the primary solution to your diabetes.

As explained in Chapter 11 of Death to Diabetes, come prepared to your appointments and ask specific questions to get the most out of your appointments.

You should ensure that you set up the necessary doctor appointments during the calendar year as specified by your doctor (Primary Care Physician). If possible, try to schedule your appointments during the same time period each year. The following is a list of the key doctor visits that you should complete during the year.

Visit	Purpose	Frequency
Primary Care Physician/ Endocrinologist	Check blood glucose, hemoglobin A1C, kidney tests, nerves (foot exam)	Every 3 to 6 months
Primary Care Physician	Physical exam; Other tests: blood pressure, cholesterol, kidneys, liver	Annual
Ophthalmologist	Eye tests for retinopathy, cataracts, glaucoma	Every 6 months or annual
Wellness coach; Dietitian/Nutritionist	Wellness planning; Nutritional planning, etc.	As required
Dentist	Cleaning of teeth and gums, dental examinations	Cleaning: every 3 mos. Exams: annual
Podiatrist	Examination of feet for nerve damage	Every 3 to 6 months or as required

You should visit your primary care physician and/or endocrinologist on a regular basis to review your progress, your blood glucose readings, corrective actions, and other notes – at least until you have your blood glucose level under control.

Depending on your health needs and your health goals, you should get a complete physical and set of blood work every 6 to 12 months to identify any trends that may be getting overlooked, especially if you’re not making any significant improvements.

Concerning your feet, you should always clean and inspect them daily. Record any abnormalities to discuss with your physician at your next visit. Keep your feet clean and moist; and wear cotton socks for better absorbency. Concerning your teeth/gums, you should always check them for any bleeding that doesn’t stop, and, notify your dentist and primary care physician immediately. Gum disease can increase internal inflammation and increase the risk of cardiovascular disease.

Depending on your health needs and your health goals, other members of your diabetes care team may include one or more of the following: cardiologist, neurologist, nephrologist, physiotherapist, naturopathic doctor, or psychiatrist. Other members may include a wellness coach, diabetes educator, pharmacist, community health nurse, or social worker.

Doctor Appointments
One of the best ways to manage your diabetes is to develop an effective working partnership with your doctor. Your doctor’s role in this partnership is to provide medical advice, offer treatment options and recommend resources. Your role is to monitor your symptoms and blood glucose readings, report them accurately and do what you can to manage your disease on a day-to-day basis.

Doctor appointments are very important, but most people come ill-prepared to take full advantage of the time with their doctor. Then, they complain about the doctor not taking enough time with them. Or, they don’t ask the doctor any pertinent questions; or, they don’t bother to take any notes and forget what the doctor told them. The doctor could spend more time with them, but they must first take full advantage of the time that they have with their doctor. Then, they will be pleasantly surprised how well their doctor responds when they take a more active role in their health.

Empower Yourself. Don't be intimidated by your doctor. Don't take what your doctor says at face value. Your doctor doesn't know everything, in fact he/she is only making an educated guess as to what is wrong with you. Use his services as a tool but don't base your life on what your doctor says or think that a few little pills he/she prescribes will fix the problem... it won't. You'll only require more pills to counteract the side effects that the first pills gave you and that will escalate with each new prescription you are given.

Don't take the easy way out. Question and research everything. The body can and does heal itself if given the right tools. Your health is the most important thing you will ever have and once it is lost, the biggest loser is you.

For more details about doctors appointments, how to plan, and how to talk to your doctor, refer to Chapter 11 of Death to Diabetes, or get the Doctor Visits and Blood Tests PDF.

Questions for Your Doctor about Treatment Options
When considering any treatment options, whether they're considered curative or palliative, there are some essential questions you will want to ask your doctor.

What treatments are available for my illness?

Your doctor should tell you what treatments are standard for your illness. Your doctor will not always share the option of palliative care or hospice without being asked directly. If you are interested in finding out how palliative care or hospice can help you, be sure to ask.
What are the chances that a particular treatment will be effective?

Some treatments are standard and very effective. If you have tried treatments before that have lost their effectiveness or haven’t worked at all, ask your doctor about less standard and experimental treatments. Knowing what the chances are that a treatment will provide relief will help you determine if the benefits of the treatment are worth any risks.
Will this treatment prolong my life?

Some treatments will target symptoms of an illness without extending life. You will want to know whether the treatment you're considering will extend your life and based on your goals of care, you can decide if that indeed what you want.
What are the risks of a particular treatment?

This may the most important question to ask. Just about every treatment has some sort of undesired consequence or side effect. Depending on your goals of care, a particular risk may not be worth the potential benefit. For example, if the treatment will likely make you feel sick, weak, and tired but not cure your illness, you might decide to forgo it to focus on quality of life.
How will this treatment affect my other medical conditions and treatments?

Some treatments have unintended effects on other medical conditions or treatments. For example, a patient with lung disease, heart disease, and kidney disease may take steroids to control lung disease, which can lead to increased water retention making their heart disease worse. Then, taking diuretics to control water retention and swelling can lead to worsening kidney failure. Finding out how potential side effects will affect any other illnesses will help you decide if the treatment is worth it.
If this treatment doesn’t work, what is our next step?

You will want to know where your heading if things don’t go as hoped. Having a plan in place will make any new decision easier to make.

Healthcare Team

People with diabetes work with an extensive diabetes care team, which may include a primary doctor, dietitian, diabetes educator, diabetes health coach, eye doctor, foot doctor, dentist, and possibly an exercise trainer. But remember, you are the most important member of your diabetes care team. Your health care team is available to help you manage your diabetes and maintain your good health.

Your diabetes care team should include most or all of the following:

You: You are the most important member of your diabetes care team. Only you know how you feel. Your diabetes care team will depend on you to talk to them honestly and supply information about your body. Monitoring your blood sugar is an important part of effective therapy. It tells your doctors whether your current treatment is effective. Your participation in monitoring your blood sugar levels will also help prevent or reduce the episodes of hypoglycemia (low blood sugar).
Primary doctor: Your primary care doctor is the doctor you see for general checkups and when you get sick. This person is usually an internist or family medicine doctor who has experience treating people with diabetes. Because your primary care doctor is your main source of care, he or she will most likely head up your diabetes care team.
Endocrinologist: An endocrinologist/diabetologist should also be seen regularly. An endocrinologist is a doctor who has special training and experience in treating people with diabetes.
Dietitian: A registered dietitian (RD) is trained in the field of nutrition. Because food is a key part of your diabetes treatment, a dietitian is very important. Your dietitian helps you figure out your food needs based on your weight, lifestyle, medication, and other health goals (such as lowering blood fat levels or blood pressure).
Diabetes health coach: one of our trained specialists in the fields of medical science, diabetes pathology, nutrition, meal planning, lifestyle, and spiritual health can help you in many ways with our phone coaching sessions.
Nurse educator: A nurse/diabetes educator or diabetes nurse practitioner is a registered nurse (RN) with special training and background in caring for and teaching people with diabetes. Nurse educators often help you learn the day-to-day aspects of diabetes self-care.
Eye Doctor: This doctor is another key member of your diabetes care team because diabetes can affect the blood vessels in the eyes. The eye doctor will be either an ophthalmologist (doctor who can treat eye problems both medically and surgically) or an optometrist (someone who is trained to examine the eye for certain problems, such as how well the eye focuses; optometrists are not medical doctors). You should see your eye doctor at least once a year.
Podiatrist: This health professional is trained to treat feet and problems of the lower legs. For anyone with diabetes, which can cause nerve damage in the extremities, foot care is important. Podiatrists have a Doctor of Podiatric Medicine (DPM) degree from a college of podiatry. They have also done a residency (hospital training) in podiatry.
Dentist: People with diabetes are at somewhat greater -- and earlier -- risk of gum disease. The excess blood sugar in your mouth makes it a nice home for bacteria, which can lead to infection. You should see your dentist every six months. Be sure to tell your dentist that you have diabetes.
Exercise trainer: Exercise plays a major role in your diabetes care, no matter what kind of diabetes you have. The best person to plan your fitness program -- along with your doctor -- is someone trained in the scientific basis of exercise and in safe conditioning methods.

How Often Should I See My Doctor if I Have Diabetes?

People with diabetes who are treated with insulin shots generally should see their doctor at least every three to four months. Those who are treated with pills or who are managing diabetes through diet should be seen at least every four to six months. More frequent visits may be necessary if your blood sugar is not controlled or if complications of diabetes are worsening.

What Information Does My Doctor Need About My Diabetes?

Generally, your doctor needs to know how well your diabetes is controlled and whether diabetic complications are starting or getting worse. Therefore, at each visit, provide your doctor with your home blood sugar monitoring record and report any symptoms of hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar).

Your doctor also should be informed of any changes in your diet, exercise, or medicines and of any new illnesses you may have developed. Tell your doctor if you have experienced any symptoms of eye, nerve, kidney, or cardiovascular problems such as:

Blurred vision.
Numbness or tingling in your feet.
Persistent hand, feet, face, or leg swelling.
Cramping or pain in the legs.
Chest pain.
Shortness of breath.
Numbness or weakness on one side of your body.
Unusual weight gain.

Refer to Chapter 11 of Death to Diabetes for more details.

What Lab Tests Should I Have for Diabetes?

If you have diabetes, your lab tests should include:

Blood glucose
Hemoglobin A1c
Blood pressure
Urine Tests
Cholesterol (lipid profile)
Cardiac risk factors (optional)

Refer to this web page for more details about blood tests.

How Many Drugs Should I Be Taking for My Diabetes?

Ideally, you shouldn't be taking any drugs for a disease that is primarily due to poor eating habits!

Unfortunately, most diabetics start out with the drug metformin (Glucophage), and eventually transition to multiple drugs, until one day they have to go on insulin.

Most diabetics take other drugs besides the diabetic drugs. The most common drugs that diabetics are given are drugs for high blood pressure (i.e. lisinopril, HTCZ) and high cholesterol (i.e. Lipitor, Zocor).

Unfortunately, the combination of these drugs tend to make your diabetes even worse.

Educate yourself about drugs, and understand the relationship between your doctor and the pharmaceutical companies.

The Truth About Your Doctor
Your medical doctor is not trained to help you with nutrient-deficient and lifestyle-driven illnesses such as Type 2 diabetes, obesity, high blood pressure, high cholesterol, chronic fatigue, and some forms of heart disease.

Doctors spend several years in medical school and internship, but most of their course work is centered on pharmacology. In addition, most medical universities are funded by the pharmaceutical companies who influence the course curriculum!

Medical doctors can only offer you two solutions to deal with your diabetes: drugs and surgery.

Your doctor may refer you to a dietitian but the dietitian will support the doctor's drug recommendations. In addition, the dietitian knows very little about the science of diabetes pathology, and they tend to put you on a calorie-restrictive low-fat diet, which doesn't really address the diabetes. Dietitians tend to focus on weight loss, which may work temporarily but you're still diabetic and you're still taking the dangerous diabetic drugs.

But, that doesn't mean your doctor can't help you! Your doctor can help you by providing a proper medical diagnosis, your medical blood tests and other key data that you will need to work with an alternative healthcare practitioner. Always obtain a copy of your blood test results and physical exam results from your doctor or his/her assistant.

So, what do you do next now that you know that your doctor can't really help you with your diabetes?

You should still schedule appointments with your doctor, other doctors and other members of your diabetes healthcare team on a regular basis.

Educate yourself about diabetes and drugs, and stop being a victim, and become a victor of wellness. Take back the power and take back your life.

Join a comprehensive diabetes wellness program such as the Death to Diabetes program. Such a program will educate you about diabetes and nutrition, and will improve your diabetes and overall health.

Find an alternative healthcare practitioner that has the proper background in science and nutrition. Use both your medical doctor and your alternative healthcare practitioner to optimize your health. If you can't find an alternative healthcare practitioner in your area, contact our office to set up an appointment with one of our altrnative healthcare practitioners or diabetes educators.

Key Point: Don't assume that just because a healthcare professional is involved in alternative medicine that they can help you with your diabetes! Most of the following alternative healthcare professionals are ill-equipped to help you with your diabetes: dietitians, nutritionists, diabetes educators, chiropractors, herbalists, wellness consultants, holistic practitioners, acupuncturists, naturopathic doctors, etc. Ensure that the person has the science background in diabetes pathology and nutrition by interviewing the person before you give him/her any of your money! Be wary if they offer a guarantee but require full payment!