By: Steve Edelman
One of the most powerful and simplemethods to take control of yourdiabetes is to follow a “diabetes warrantyprogram.”
The concept is simple and is similar to thewarranty program for a new automobile.If you follow the regularly scheduledmaintenance program recommended by themanufacturer, your new car will run betterand last longer. I designed the diabeteswarranty program in order to prevent theonset and to delay the progression of thecomplications of diabetes. If you follow theregularly scheduled maintenance programrecommended by leaders in the field ofdiabetes, you will feel better and last longer!
All diabetics need a maintenance recordbook that lists the recommended tests withdates and results. This information is vital,primarily to those of us with diabetes, andsecondarily to our caregivers, to diagnoseand track the common problems that occurwith diabetes. In many cases, your recordwill be more orderly and complete thanthe one in your medical chart. Because itisn’t uncommon to change physicians, yourrecord keeping takes on an even greaterimportance.
The important issues are listed below anddiscussed in my book in detail:
How Often Should You Be Seen by aPhysician?
If you are currently on insulin therapy, yourphysician should see you approximatelyevery three to four months. If you are not oninsulin, you should be seen approximatelyevery three to six months. The frequency ofvisits depends on how well or how poorlyyou are doing and on whether you haveyour diabetes in control. When you visit yourphysician, be prepared to discuss your mostimportant concerns.
What Should Happen at an Office Visit?
The standards of care require that certainbasic procedures be done at an officevisits. These include taking measurementsof weight and blood pressure, discussinghome blood glucose monitoring resultsand laboratory values, such as A1Cs, whichshould be drawn a few days before theappointment. A foot exam is also in order,especially if the patient is experiencinga problem or has any loss of sensation(neuropathy).
What Tests or Exams Should Be DoneAnnually?
Certain tests and exams must be done everyyear, if not more often, in order to initiateaggressive therapy when needed to avoidthe complications of diabetes. A yearlycholesterol panel (HDL, LDL, triglycerides), atest of how your kidneys have been affectedby diabetes (urine test for microalbumin, forexample), and thyroid levels are a few of theimportant tests. The yearly dilated eye examis a must for all people with diabetes and,depending on your other medical problems,you may need to see an ophthalmologist, cardiologist,podiatrist, dentist, stomach specialist or other medicalspecialists on an annual or more frequent basis.
What Should Be Discussed With Your Caregiver?
Don’t go to your doctor’s office with a list of questionsthat is half a mile long! This will put the usually overscheduleddoctor immediately on edge. Decidewhich issues are the most important to you. Try to doyour homework first and learn about the topic of thequestion so that you can get the most out of your officevisit. Again, this is like going to an auto mechanic for aparticular problem; if you know a little about cars andhow they work, you will understand the mechanic’sexplanation of what is wrong with your car a lot better.
Write Up Your Own Diabetes History Sheet
It’s helpful to have a basic information sheet about yourmedical history. Much of your medical history does notchange and is easy to update periodically. You can thenbring a copy of your medical history, along with yourdiabetes warranty program sheet, to any healthcareprofessional, such as your dentist, physician, nurse orpharmacist. Having your history already written up cansave time for other important issues that arise duringyour appointment. You should record your medicalproblems, when they started, what medications youhave tried in the past and what you are taking now. Besure to list any allergies and any surgeries and diseases orconditions that run in your family.
How to Ask Your Caregiver for an Exam or Test
If a test or examination has not been done that is neededto comply with your diabetes warranty program, youshould discuss this with your caregiver and requestthe test or examination. Phrase your comments andquestions constructively and not aggressively. Forexample: “Would it be possible to check my cholesterollevels at my next visit? My last values were done over ayear ago, and I am concerned about them.”
You must work with your caregiver in order to maintainyour health and quality of life. Staying healthy is mucheasier when preventive measures are taken early. This iswhat taking control of your diabetes is all about.