As mentioned last week, a diabetic consultation is sometimes quite different from any other consult with your doctor. The focus of this consultation should be on gaining information about changes in your lifestyle, adapting your management plan to suit that and in actively looking for problems related to your diabetes. We all have a grandfather or aunt or even friend who had diabetes and then towards the end of their life suffered terribly with poor eyesight, kidney or heart problems or even unrelenting foot problems. THIS DOES NOT NEED TO BE THE END OF THE ROAD FOR PEOPLE WITH DIABETES! I always say to my patients if you were about to embark on a long road trip, would you not go and get your car serviced before you go, check your tyres and make sure it’s in top condition for the trip? Obviously, the more time you spend on the road, the more at risk you are of having an accident or a blowout but by checking these things before you go, you can reduce this risk. Fairly similar with diabetes. If we as health care professionals KNOW that those with diabetes are at risk of developing various complications, then surely we need to check for them on a regular basis?? Diabetes consultations are not just a 5-10min revisit of your medication or a kind doctor who agrees to rewrite your chronic script every six months to save you the time and expense of coming in for an appointment. Regular consultations with your diabetic doctor, nurse educator (DNE), dietitian and other specialists are the cornerstone of diabetes therapy.

So, what should you expect? The new SEMDSA guidelines document that there is scientific evidence to support the practice of regular visits to dedicated health professionals with adequate facilities in order to improve diabetes outcomes. Don’t forget to take your glucometer, medications etc as described last week. Your doctor / DNE may as many questions about your diet and exercise habits, your general health, specific risk factors, family history, past medical history etc. All of these are important indicators in managing diabetes optimally. A targeted clinical examination is important as is a review of your glucometer and individual readings. This may take some time to analyse properly and your doctor should explain the results so you know where to target any changes. Discussing possible changes in medication is also important rather than a simple re-scripting of previous medication. Remember, diabetes changes as time goes on so even if you are eating the same as always and your activity is similar, you may still require changes in your medication.

Other appointments that you may require on a regular basis are regular eye screening, foot screening and blood tests. Usually these are done either once or twice a year depending on your individual needs. Immunisations, pregnancy planning and lifestyle adjustments (stopping smoking, managing alcohol etc) may also require specific attention. Regular advice from a dietitian trained in diabetes should also be tailored according to your needs. So what is left…..? The all important diabetic nurse educator! If you have never seen a DNE or last saw your DNE more than 6 months ago, you are MISSING OUT! Read the blog next week for more information!