Dear all,
Most times, patients enter a doctors’ office and they have no idea what to expect or what their doctor should be able to provide to them as part of management. Treatment in diabetes is broad and entails far beyond medicine and blood tests.
To improve your blood sugar control and subsequently decrease risk of complications from diabetes, the following questions are important to discuss with your doctor.
1. How is my diabetes control? This will lead to a discussion about your blood sugar ranges (hopefully you provided them to your doctor) and the HBA1C level. It is important to understand that HBA1C is an average of 3 monthly sugars, therefore cannot give a clear picture of blood sugar control without daily ranges of sugars. I will give an example; two patients both with an HBA1C of 7% shall be deemed well controlled. But looking at blood sugar ranges we can see that patient A has better control since blood sugar ranges are always within normal ranges.
Patient B on the other hand, might have an average that is good but daily readings show that he is accommodating his high sugars with low sugars, so they cancel out. If you do not have the blood sugar ranges, it is easy to assume both patients are ok, yet patient B due to the spikes and lows is at high risk of complications.
2. How is my sensation on the feet? This can be answered through a clear history and by doing a simple test called the 10g monofilament that checks for sensation of touch. More advanced tests can also be done once a year such as the vibrotherm, which is a machine that checks for hot and cold perception and also vibration sense.
3. Is the blood flow to my feet ok? This can be elicited by doing a test called ABI (Ankle Brachial Index) it’s simple, noninvasive and should be done once a year.
4. What other doctors should I see? Generally, if a diabetic patient has no other complications, they should be seeing their dentist and ophthalmologist (eye specialist) atleast once a year.
5. What are the main side effects of my medication? Your doctor should be able to explain the commonest side effects of the medication you are on. In case of symptoms you develop and you feel are due to the medication. DO NOT STOP MEDICATION. Make a visit to your doctor to explain.
6. What type of diet should I have? There is a lot of talk out there regarding what diabetes patients can or cannot eat. It is important to get a nutrition review from your doctor. This will be individualized to your needs and by nutritionists who know how to handle diabetes.I hope this helps and next time you go see your doctor you’ll enjoy a full well-rounded consultation.
Kind regards:
Dr. Salwa Shahbal
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