Kelly Rawlings is the editor of Diabetes Forecast magazine and board member of the National Certification Board for Diabetes Educators. She has also been a guest on Diabetic Connect Twitter chats.
It’s the night before my endocrinologist appointment, and all through the house are the sounds of mutterings. I’m struggling to install the data management software that came with my new insulin pump and continuous glucose monitor. Without blood glucose data, my doctor will be unable to suggest tweaks to the overnight automatic insulin doses my pump gives me. I’ve been low during a couple of 2:00 a.m. blood glucose checks, and we need to fix that.
Going into any diabetes checkup, my doctor and I face many challenges. First, the system doesn’t give us much time: if we’re lucky, maybe 15 or 20 minutes. At least my appointment is early in the morning when late arrivals and emergencies haven’t yet affected the schedule.
Much to do
During our precious time, my doctor and I need to review my blood glucose data, go over my list of current medications, check that I’m up to date on all the recommended diabetes health checks, note any new symptoms, and discuss any emotional or mental issues I’ve had in taking care of myself. My doctor is a specialist, so we can stay focused on diabetes during this visit—for people who see a general practitioner about diabetes and all other health concerns, it can be even more challenging to fit everything in.
The only way we’ll get through all we need to discuss during my appointment is if both of us are prepared. I’ve attended my fair share of diabetes appointments in the past 42 years for which I did not prepare. To myself and my healthcare providers at the time, I apologize. What I’m interested in, moving forward, is how to get the most out of my doctor visits.
How to prep
The article “How to Prepare for a Diabetes Visit,” from Diabetes Forecast magazine, has a quick list of the main items to prepare and consider before an appointment:
• List your meds and any refills you need.
• Bring your blood sugar numbers. The A1c blood test, a measure of average blood glucose levels for the previous two to three months, doesn’t tell the whole story.
• Prep your questions. (Write them down so you don’t forget!)
• Be empowered. It’s YOUR appointment, your right to understand what your healthcare provider is saying, and your responsibility to ask questions.
To track your blood glucose levels, exercise days, foods, and more, notes on paper are fine. Some people seem to prefer using their ever-present smartphone and one of the many diabetes tracking apps and management programs available, such as MySugr and MyDiabetesHome.com.
Important health checks
I like to bring a list to remind my doctor and myself of recommended diabetes health checks. That way, we’ll know whether I’m up to date on my kidney function urine test and other important health screenings. The list of health checks reminds me to mention my recent dilated eye exam and celebrate the good news from that. I’m showing no signs of the macular edema (swelling near the part of the eye responsible for central vision; problems here can lead to vision loss) that we spotted a couple of years back. Tighter diabetes control and frequent dilated eye exams to watch for any signs of progression that may require laser surgery have helped me conquer that complication.
Doctors have their own versions of the recommended diabetes health checks, usually based on the Standards of Medical Care in Diabetes, published each year by the American Diabetes Association. The guidelines cover clinical care for the full spectrum of people affected by diabetes including all ages, types, durations, life stages, and related complications.
Ready, set, go
One of the final things I do to prepare for an appointment is think about what I’ll wear. I usually select a shirt that unbuttons so the doctor can listen to my heartbeat and the lab tech has easy access to the vein at the crook of my elbow. For a psychological boost (and a handy visual reminder not to forget the foot exam), I like to wear colorful socks to my appointment. And, of course, I choose clothes that aren’t super heavy; I know I’ll be stepping on the scale!
Many things outside our control can affect how a diabetes checkup unfolds: limited parking spaces near the office, another patient’s emergency hospitalization, or the number of appointments the health system expects to squeeze into each hour. I know, however, that I play a major role turning the visit into a victory for my health and well-being.