Diabetes: Roles on Your Care Team

Topic Overview

Your primary care doctor is responsible for the day-to-day medical management of your diabetes. (This doctor is usually an internist or a family medicine doctor.) He or she also may coordinate your diabetes care. Or a nurse practitioner, nurse educator, or physician assistant may coordinate your care.

Your health professional will help you find the right oral medicine and possibly insulin to regulate your blood sugar (glucose) level. He or she also will help you adjust medicines as your diabetes changes. For this reason, be sure to tell your health professional if your symptoms change.

Most primary care doctors are excellent at managing diabetes. But if your symptoms get worse or if you have complications, you may need to see a specialist. This is a doctor who has extra training in a particular field. You should see some specialists, such as an ophthalmologist and podiatrist, regularly. These specialists provide care to prevent eye and foot problems from diabetes.

Other specialists are seen only when a problem occurs. For example, if you have a complication that affects your heart, you may need to see a cardiologist. For kidney problems, you may need to see a nephrologist. An orthopedic surgeon can help with bone, muscle, or joint problems. For some people who have diabetes, it is important to see these specialists at least once a year so they can monitor the complication.

Roles of specialists

Team member	Specialty	Role	How often seen
Endocrinologist	Endocrine system	This doctor treats complex cases of diabetes with difficult-to-control blood glucose levels.	Sometimes regular visits, or as treatment problems arise, such as you cannot stay within a target range and hemoglobin A1c levels are higher than desired
Nephrologist	Kidney	He or she treats problems related to kidney failure.	As kidney problems develop
Ophthalmologist or optometrist	Eye	These doctors monitor your eyes for diabetes complications and treats any vision problems.	Regularly, at least once a year
Cardiologist	Heart	He or she treats problems related to the heart and circulatory system.	As problems arise
Neurologist	Brain	This doctor treats brain and nerve disorders, such as strokes and diabetic neuropathy.	As problems arise
Podiatrist or orthopedic surgeon	Foot	They help you monitor your feet and treat any problems, such as foot ulcers.	As needed for foot problems. Have your primary care doctor check your feet once a year.

Other health professionals on a diabetes care team

Other health professionals who may be involved in your diabetes care include:

• Mental health professional. Many people with chronic diseases have depression. A psychiatrist, psychologist, or social worker can help you deal with the mental challenges that may come with living with diabetes. Also, one of these specialists can help you learn to manage stress. (Stress can affect your glucose control.)
• Exercise physiologist. Physical activity is an important part of your treatment for diabetes. You may want to work with an exercise physiologist to develop an exercise program that suits your fitness level. Exercise physiologists work with people at all levels of strength and aerobic fitness. He or she can help you plan strategies for staying with your exercise plan.
• Registered dietitian. Your diet plays a key role in keeping your blood sugar levels within a target range. Registered dietitians have training in nutrition and can help people make meal plans and other changes in their lifestyle. Changing your eating habits may be the hardest thing for you to do to care for your diabetes. A registered dietitian can help you take small steps toward a balanced diet.
• Nurse educator. A nurse educator helps you understand your diabetes and its treatment. As your disease changes and progresses, your nurse educator can give you the information you need to adjust and change with it. He or she may also coordinate your diabetes care.