After you've been diagnosed with type 1 diabetes, you'll need close medical follow-up until your blood sugar level stabilizes and your doctor determines the most effective type and doses of insulin for you. A doctor who specializes in hormonal disorders (endocrinologist) generally coordinates diabetes care, but your health care team likely will include:
- Certified diabetes educator
- Social worker
- Doctor who specializes in eye care (ophthalmologist)
- Doctor who specializes in foot health (podiatrist)
Once your blood sugar is under control, your endocrinologist likely will recommend checkups every few months. A thorough yearly exam and regular foot and eye exams also are important — especially if your diabetes isn't well controlled, if you have high blood pressure or kidney disease, or if you're pregnant.
It's good to prepare for your appointments, which may include visits with several members of your health care team as well as your primary doctor. Here's some information to help you get ready for your appointment and to know what to expect from your doctor.
What you can do
- Write down any concerns you have as they occur. Once your diabetes is in good control, the initial symptoms of diabetes should disappear. However, you may have new issues that you need to address, such as recurring low blood sugar episodes or how to address high blood sugar after eating certain foods.
- Write down key personal information, including any major stresses or recent life changes. Many factors can affect your diabetes control, including stress.
- Make a list of all medications, vitamins and supplements you're taking.
- For your regular checkups, bring a book with your recorded glucose values or your meter to your appointments.
- Write down questions to ask your doctor.
Preparing a list of questions can help you make the most of your time with your doctor and the rest of your health care team. For type 1 diabetes, topics you want to clarify with your doctor, dietitian or diabetes educator include:
- The frequency and timing of blood glucose monitoring
- Insulin therapy — types of insulin used, timing of dosing, amount of dose
- Insulin administration — shots versus a pump
- Low blood sugar — how to recognize and treat
- High blood sugar — how to recognize and treat
- Ketones — testing and treatment
- Nutrition — types of food and their effect on blood sugar
- Carbohydrate counting
- Exercise — adjusting insulin and food intake for activity
- Medical management — how often to visit the doctor and other diabetes care specialists
Don't hesitate to ask any other questions.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
- How comfortable are you managing your diabetes?
- How frequent are your low blood sugar episodes?
- Are you aware of when your blood sugar is getting low?
- What's a typical day's diet like?
- Are you exercising? If so, how often?
- On average, how much insulin are you using daily?
What you can do in the meantime
If your blood sugar isn't well controlled, or if you're not sure about what to do in a certain situation, don't hesitate to contact your doctor or diabetes educator in between appointments for advice and guidance.
Jan. 23, 2013
- Diabetes mellitus (DM). The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec12/ch158/ch158b.html#sec12-ch158-ch158b-1105. Accessed Sept. 30, 2012.
- Standards of medical care in diabetes — 2013. Diabetes Care. 2013:36:S1.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Sept. 23, 2012.
- Your guide to diabetes: Type 1 and type 2. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/type1and2/index.htm. Accessed Sept. 23, 2012.
- What people with diabetes need to know about osteoporosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Conditions_Behaviors/diabetes.asp. Accessed Sept. 30, 2012.
- Bainbridge KE. Diabetes and hearing impairment in the United States: Audiometric evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Annals of Internal Medicine. 2008;149:1.
- Before pregnancy. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/pregnant-women/before-pregnancy.html. Accessed Sept. 30, 2012.
- A1C. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/?keymatch=a1c. Accessed Oct. 1, 2012.
- Bergenstal RM, et al. Effectiveness of sensor-augmented insulin pump therapy in type 1 diabetes. New England Journal of Medicine. 2010;363:311.
- Stem cell information. National Institutes of Health. http://stemcells.nih.gov/info/scireport/chapter7.asp. Accessed Feb. 24, 2011.
- Elleri D, et al. Closed-loop insulin delivery for treatment of type 1 diabetes. BMC Medicine. http://www.biomedcentral.com/1741-7015/9/120. Accessed Oct. 1, 2012.
- Take charge of your diabetes. Centers for Disease Control and Prevention. http://www.cdc.gov/diabetes/pubs/tcyd/vaccin.htm. Accessed Sept. 30, 2012.