Diabetes Self-Management Articles

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Planning for a Successful Health-Care Visit

by Janet Howard-Ducsay, RN, CDE

If you have dropped a few excess pounds since your last appointment, share how you did it, accept any positive reinforcement that is offered, and take pride in your accomplishment. If your physician chooses to respond to your weight loss with a negative comment — telling you it’s not enough, for example — respond with a positive attitude anyway. Try saying something like, “I will work on making the best food and activity choices I can for myself each day. I will update you on my progress with that at my next appointment.”

Discuss your medicines
Bring a current list of all of the medicines and the doses you are taking to each appointment, or bring the bottles of medicines themselves if that’s easier. Go over the list with your physician to make sure he is aware of what you’re taking. Identify before your appointment whether you will need to get new prescriptions from your doctor for any of your drugs or diabetes supplies. If you’re not sure when or how much of a drug to take, ask. For example, you might say, “Dr. Smith, I am taking 5 milligrams of glipizide 30 minutes before each meal. Is that correct?”

Include any over-the-counter or herbal products on your list, and mention if you have started taking any new products since your last appointment. Ask whether these new products might interact with anything else you’re taking.

If you are not taking your prescribed medicines, tell your doctor, and say why. It is better to be candid about what’s going on than to have your provider prescribe more medicines because your blood glucose levels are too high (which they are likely to be if you’re skipping your medicines).

Are your medicines too costly? Ask your provider if there are lower-cost alternatives. If there has been a recent change in your financial situation, the doctor’s office staff can provide you with information about pharmaceutical assistance programs that may help to cover the cost of your medicines and diabetes supplies. The Partnership for Prescription Assistance Program, which can be found online at www.pparx.org or contacted by telephone at (888) 477-2669, has the application forms for many pharmaceutical assistance programs.

Money is not the only reason people don’t take their prescribed medicines. Perhaps you are not taking them because you are depressed or sick and tired of having diabetes. Just saying it out loud can be a relief, particularly if you are heard by an empathic ear. Verbalizing how you feel can also open an important dialog with your doctor about your emotional well-being. In addition to offering a supportive ear, he may be able to suggest other resources, such as a therapist or diabetes support group. Similarly, if side effects or forgetfulness are causing you to stop taking your medicines or to skip doses, your doctor may be able to help you work out solutions to these problems.

Take off your shoes and socks
Take your shoes and socks off when you enter the examining room, and remind your provider to examine your feet. Tell him about any foot-related concerns you may have, such as any tenderness, redness, irritation, changes in sensation, or slow-healing wounds you have observed in your daily foot exams. If you’re having trouble trimming your toenails or finding shoes that fit, ask about a referral to a podiatrist. Even if you have no specific concerns about your feet, it’s important for your provider to check them for the presence of neuropathy, which can cause you to lose feeling in your feet and to not notice small or even large injuries.

Discuss your goals
Tell your doctor what your goals — or priorities — are regarding your diabetes. For example, your main goal may be to avoid highs and lows. Ask your doctor how this compares to his goals for your diabetes care. You may find that your priorities are somewhat different. For example, his main goal may be to bring your HbA1c level into target range.

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