Diabetes
Patient Education

Doctors Who Treat Diabetes - Patient Education

As your diabetes is diagnosed, treated and managed, there may be several specialists you are referred to for care. The most common doctors that treat diabetes include:

Endocrinologist. Doctor who monitors conditions that affect your glands and hormones along with how these hormones affect your body systems.

Ophthalmologist. Doctor who specializes in the health of the eyes. It is important that a diabetic patient see this doctor annually to detect conditions such as retinopathy - small blood vessel changes that lead to blindness - and edema, the swelling of the retina which can lead to blurred vision.

Podiatrist. Physician who specializes in the foot. It is important for a diabetic patient to be evaluated by the podiatrist to detect poor circulation.

Additional physicians that diagnose and treat diabetes include:

• Pediatricians and pediatric endocrinologists
• Internists
• Gerontologists
• Obstetricians

How to Prepare for Your Diabetes Doctor Visit

When a patient is going for a blood test related to their diabetes, they cannot eat or drink for at least 8 hours prior.

There are several known medications and foods that can alter the results of blood sugar tests. Try to avoid consuming these drugs and foods while fasting in order to avoid a false reading.

Medications to avoid before a test

If you are taking a drug that affects your blood glucose level, it is prudent to notify your physician prior to the exam.

Medications that elevate blood sugar	Medications that lower blood sugar	Medications that mask blood sugar
Skin conditions - typically for dry, scaly itchy patches High blood pressure Mental illness and mood disorders Attention deficit and hyperactivity disorders Cancer HIV/Aids Fungus Congestive Heart Disease Cold and cough remedies Glaucoma Inflammation	Cold and Epilepsy Infections Hypertension Pain, Inflammation Vitamin supplements (especially with Aloe or Ginseng) Colds Heart conditions Malaria	Hypertension Glaucoma Heart failure

Warning: Do not discontinue medication without first consulting your healthcare provider.

In addition to prescribed medications, other foods and over the counter medications that you take at home can also affect your blood pressure. Prior to a blood test, avoid:

Alcohol
Caffeine
Carb-heavy foods
Over the counter cold medications
(Those with pseudo ephedrine and phenylephrine)
Continue reading our patient education guide for more information on how to prepare for your doctor visit.

Questions to Ask Your Doctor About Diabetes

From your initial diagnosis throughout your treatment and care, you will have questions about your diabetes. This patient education guide contains is a list of helpful questions for you and your doctor to discuss so you can make informed decisions about your condition.

Questions About My Diagnosis

1. What is the difference between Type I and Type II Diabetes and which one do I have?
2. Are there other conditions associated or caused by diabetes?
3. What organs or body functions can be affected by diabetes?
4. What symptoms might I experience when my blood sugar is too high? Too low?

Questions About My Treatment

1. Are there other specialists that I should see for routine care for my diabetes? How often will I need to go?
2. Will I be able to control my diabetes with diet and exercise or will I need insulin injections?
3. What is my dose and how do I inject the medicine? Are there side effects?
4. Are injections paid by my insurance?
5. How do I store my medication? Does it need refrigeration or is room temperature permissible? How do I dispose of used needles?
6. If my blood sugar tests in the normal range, do I still need to take my medication?

Questions About My Lifestyle and Family

1. Is diabetes hereditary? How does this affect my children?
2. Can I get pregnant? Will I have infertility problems?
3. If I get pregnant, what risks will I face?
4. What type of diet will I need to be on?
5. Will my activity or daily routine be restricted? Can I participate in sports?
6. Can I travel by plane with my needles and syringes?

Common Tests or Labs to Diagnose Diabetes

There are several tests and labs used to make a diabetes diagnosis and monitor your ongoing condition. Listed below in this patient education guide are the most common tests and labs ordered, why you need them, and what they can tell you about your condition.

Name	What's tested?	How does it work?	What is normal?
Blood test	Blood Glucose	Venous blood is removed from the arm and the sugar level is analyzed.	Normal is 70-100 milligrams/deciliter > 125 mg/dL on two tests is considered diabetes
Blood test	Oral Glucose Tolerance Test	Blood is drawn to test the fasting sugar level. Flavored drink is given with 75 gms of glucose (100 gms in pregnancy) Blood is drawn 4X over 3 hrs	<140 mg/dl for 2nd hr <200 between 0 and 2 hrs Diabetes is diagnosed when more than two values are abnormal (on two different days)
Blood test	Random Blood Sugar	Venous blood is removed from the arm and the sugar level is analyzed	<140 mg/dl for 2nd hr <200 between 0 and 2 hrs Diabetes is diagnosed when more than two values are abnormal (on two different days)
Eye Exam	Retinal Evaluation	Pupils are dilated and the optic nerve, blood vessels and interior eye lining are assed using an ophthalmoscope.	There should be no edema (swelling) or narrowing of the nerve and vessels.
Blood Vessel Assessment (over external body/skin surface)	Vascular Ultrasound	Sonogram evaluates blood flow using high-frequency sound waves.	Normal would fail to show vessel narrowing or flow blockages due to clots.
External Exam (body/skin surface)	Doppler evaluation of blood flow	Evaluates blood flow through a blood vessel including flow to vital organs.	Normal would be consistent, continuous flow with no blockage.

Common Medications and Treatments for Diabetes

While there is no cure for diabetes, a combination of diet, exercise and medication is effective in controlling blood sugar and preventing or delaying symptoms and diabetic related illness. Read more in this diabetes patient education guide.

Medications for diabetics typically fall into two categories: oral hypoglycemics taken by mouth and insulin, which is injected into the body.

Oral Hypoglycemics:

Types of Insulin

Your insulin prescription will be determined by a number of factors.

• Type of diabetes
• How often you can check blood sugar
• How often you give injections
• Your age
• Your body's response
• Your lifestyle (diet, daily activities, exercise)

Type	When to Administer	What it Does	How long it works
Basal	Once or twice per day. May be given in conjunction with oral medication or bolus insulin.	Controls glucose level through the night and between meals.	Intermediate-acting starts in 1-3 hrs works for 12-16 hrs NPH Long-acting starts in 1 hr works for 20-26 hrs glargine, detemir
Bolus (meal-time)	Given prior to meals. Usually in conjunction with basal insulin.	Regulates the spike of blood sugar levels after eating.	Short-Acting regular insulin starts in 30-60 minutes works for 5-8 hrs Rapid-acting starts in 15 minutes works for 3-5 hrs lispro,aspart,glulisine
Pre-mixed	Given twice each day. Administered prior to breakfast and dinner.	Regulates blood glucose between and after meals.	Combination of intermediate-acting with bolus insulin types starts in 15-60 minutes works 10-16 hrs with or without oral hypoglycemic drugs

Insulin Devices

Several device types are now available to inject insulin rather than using the standard needle and syringe.

Type	Insulin Pens	Insulin Pump	Injection Port	Insulin Jet Injector
What is it?	Shaped like a pen with a refilled and/or replaceable cartridge.	Size of a cell phone or deck of playing cards, the insulin pump is worn on a belt or in pocket.	Gives a steady trickle amount of insulin through the day	A tube is inserted beneath the skin for insulin injections. Sends fine spray into skin at high pressure.
Advantages	Easy to use and disposable. Some patients claim they are less painful than standard needles.	Predictable insulin levels and actions (long and intermediate-acting insulin are not used with the pump)	Decreases the number of skin punctures.	Insulin is injected fast. With insulin needles, the syringe stays in the skin for 6 seconds to prevent insulin leaking back through the injection site.