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How to Talk to Your Doctor

Whether you’ve been living with diabetes for years or you’re newly diagnosed, communicating with your healthcare team is one of the best things you can do. If you’re nervous about opening up to your doctor or pharmacist, there are some good reasons to conquer these fears. Less communication leads to measurable increases in your stress, anxiety, and possible depression. It also leads, inevitably, to less frequent and less successful diabetes management.1   Since communicating with your healthcare providers is proven to be good for your health, here are some guidelines for starting the conversation and keeping it going.   Know who’s on your healthcare team. If you don’t already know the people involved in your healthcare, get to know them. Your healthcare team could include: Primary care provider Pharmacist Nurse or certified diabetes educator Dietician Endocrinologist Eye doctor Therapist Podiatrist You may not need to see everyone on this list, but it is a good idea to know who to turn to when you have specific questions.   You have a say in your healthcare. The most important member of your healthcare team is you! Other than doing what it takes to manage diabetes day-to-day, this also means that you have a say in your treatment. In fact, your healthcare provider should explain your diagnosis and all of your treatment options to you so that you can make an informed decision with regard to your health. The World Health Organization provides a great overview of informed consent, including which treatments require written consent (like surgery) and what you should expect to happen during the informed consent process.2   How much do you want to know? Sometimes the medical details can be overwhelming or intimidating. If you would rather not know these details right away, feel free to tell your doctor or pharmacist. Just make sure you find a comfortable balance between what you want to know and what you need to know in order to successfully manage your diabetes. If knowing every clinical detail puts your mind at ease and makes you feel more in control, tell your doctor this, too.   Know what to discuss and ask about. You will likely have general questions you’d like to ask your healthcare provider when you see them—new symptoms, any changes to your treatment, etc. It’s best to get those out of the way first. Make sure you also ask questions about sensitive topics or any other issue that is important to you. And if you’ve decided to add alternative medicines or treatments to your regimen, be open and honest with your team. These conversations are for a good cause: your health!   Do you know about your medical tests? It’s important to take the medical tests your healthcare provider requests, but make sure you ask questions about them too. Some questions to ask: Is there anything you need to do before the test? What will the test measure? How will the test influence any changes to your treatment? Are there risks to taking the test? How will you be informed about the results?   Know what to do before and after your appointment. If you know there are issues you need to discuss with your healthcare provider, organize your thoughts ahead of time. Jotting them down and bringing the list of questions to the appointment can keep the meeting on track and make you feel confident that you’re getting the information you need. After your appointment, don’t hesitate to follow up if you have questions about your treatment. For example, if you received test results that you don’t understand, make a phone call.   Problems talking to your healthcare provider? Yes, doctors are busy, but they are there to serve you and there is no reason for you to delay or forego getting the information you need about your health. If you can’t seem to get a clear answer from your doctor on an issue, try saying, “I don’t understand [this topic]. Can you take a few minutes to explain it to me?” If your healthcare provider can’t make the time for a conversation, offer to make an appointment for a phone call to discuss your concerns. An “advocate”, a friend, or family member that understands more about diabetes can also help by going to medical appointments with you. Never give up on getting the knowledge you need.

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Creating a Circle of Support

No one can go it alone. Whether you have diabetes or you’re a caregiver, it’s important to have a few options for emotional support. Knowing who to turn to with specific questions will make life easier.   Find other people with diabetes Few things are more comforting than talking with someone who understands you when you have diabetes, or if you are facing a type 1 or type 2 diagnosis. If you don’t already have a friend or family member with diabetes who can fill this role, seek out a diabetes support group near you. What have you got to lose? If you don’t like one group, look for another until something clicks. Another great way to find others who support people with diabetes friends is to volunteer or join fundraising events of diabetes non-for-profit groups.   Join the DOC The DOC is the Diabetes Online Community, a deep well of inspiration and support, all online. There are dozens of options: message boards, private groups, social media, blogs…people with diabetes are online everywhere. You can look for private groups on social media sites like Facebook. Some popular message boards live at TuDiabetes and Children with Diabetes.   Know your healthcare team You’ve worked with your healthcare providers to lay out a plan for controlling your diabetes, so don’t let all that hard work go unused. Make (and keep) regular appointments with your primary physician, and find someone like a nurse or diabetes educator you can contact whenever you have questions about your health.   Enlist your child’s school If your child has diabetes, build a team of caretakers for your own peace of mind. Ask the principal (school principal, headteacher, headmaster, headmistress) to arrange a meeting between you and anyone who needs to understand your child’s diabetes needs—office workers, the school nurse, all teachers, coaches, and even transportation or field trip chaperones. The Kids and Diabetes in Schools (KiDS) project is a valuable resource for creating a supportive environment at school. Download the information pack, which is divided into sections for teachers, parents of children with diabetes, children with diabetes, and parents in general. It’s available in 8 languages; it’s free, and can be used with any educational session you arrange with your school.   Additionally, get a clear understanding from your doctor about how the school day should work properly, and then make sure that the school understands your child’s daily treatment needs. The school nurse is your best friend. They’ll be your biggest asset when it comes to teaching other staff at the school about how to care for your child. Above all, don’t get discouraged. Learning curves are high for the first few weeks, and that’s okay.   Educate your family and friends One of the tasks that comes with living with diabetes is educating the people around you who aren’t living with it. You may feel like it’s not working, but keep educating, always speak up, and be clear about what really helps you (and what doesn’t). In time, everyone will be on the same page. And if there’s ever an emergency, they’ll know what to do.

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Managing Sick Days

Feeling fine? It's the perfect day to create a sick day plan. When you're feeling ill, you'd like nothing more than to lie in bed with a good book or movie. Yet that's when you need to focus even more on diabetes self-care.   The key to sick days with diabetes is doing all of the thinking ahead of time. That way, when you don't feel like concentrating, you can simply follow the plan.   What to include in your plan Involve your diabetes care healthcare team in developing your sick day plan —ask them when you should call for help, how often you should check your blood glucose and ketones, what medicines to take and what to eat.   Gather a sick day kit so the additional items you might need will be ready.   Sick day kit checklist Thermometer Pain reliever Sugar-free cough syrup or throat lozenges Decongestant (keep in mind that even sugar-free decongestants may cause a rise in blood glucose) Urine ketone strips Extra blood glucose test strips and lancets Extra insulin and supplies Glucagon emergency kit Easy-to-eat foods that contain carbs At the first sign of illness Understanding how illness might affect your blood glucose can help you take the right steps to care for yourself. For example:1 If you use insulin, don't stop taking it. Even if you are having trouble eating, you will likely need extra insulin to combat the hormones that often cause high blood glucose during illness. You might do this by raising meal or correction boluses, or using a temporary basal rate on an insulin pump. Follow your healthcare provider's recommendations. Monitor blood glucose levels more frequently, at least every 1 to 2 hours. Check your urine for ketones if blood sugar is high. Stay hydrated. Drink calorie-free, caffeine-free, clear liquids. Make sure you eat according to your regular meal plan. Keep easy-to-eat, fast-acting carbohydrates available. They can be useful in treating a low, as well as substituting for a meal. If you feel nauseated or are vomiting, try a sports drink, juice, regular soda or even frozen fruit bars to get the carbs you need. Talk to your diabetes care provider about any medications you take, or any unexpected blood glucose results you experience while taking them. Some cold medicines, antibiotics and other prescription and over-the-counter drugs are known to affect blood glucose levels.2   When to contact your healthcare team Get in touch with your doctor any time they recommend, as well as when you:1 Have been sick or had a fever for a couple of days without improvement. Have had 2 or more vomiting or diarrhea episodes within 4 hours. Detect moderate to large ketones in your urine. Have blood glucose higher than 15 mmol/L after increasing insulin and fluids. Experience symptoms that might signal ketoacidosis or dehydration, such as worsening abdominal pain, trouble breathing or breath that smells fruity or like acetone.   The key to successfully navigating an illness is preparation. By creating your sick day plan and kit before you experience the first signs of illness, you'll be ready to attack a virus head-on.

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