The time for your visit is fleeting, and to make the most of your face-to-face time with your doctor, be prepared to answer your doctor’s questions and be ready to ask him or her some of your own.
“The more informed a patient is, the better the chances of managing their disease.” So says Rifka Schulman, MD, director of the diabetes residency at Long Island Jewish Medical Center in New Hyde Park, New York. Here are some questions that will help people with type 2 diabetes prepare for their next checkup
1. How are your blood sugars these days?
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“That’s always the first question I ask people with type 2 diabetes.” says Wesley Mills, MD, PhD, of St. Vincent Community Medical Center in Jacksonville, Fla.
During most visits, doctors order a blood test to measure glycated hemoglobin (HbA1c) levels. This measure represents the average blood glucose level over the past 2 to 3 months and helps doctors know if the treatment plan being used for the patient is working.
But blood glucose measurements at home are also important. “They provide a more comprehensive overview of health and help patients and doctors understand the impact lifestyle factors such as diet and stress have on blood sugar.” Wesley says. Doctors are likely to ask to record readings on blood glucose meters and test strips 2 or more times a day, especially in patients who use insulin.
For patients who are managing their diabetes with other medications plus diet and exercise, doctors will ask for measurements 2 to 3 times a week and additional measurements if they feel uncomfortable. Detailed results should be recorded in a log or notebook and taken to the doctor.
2. Do you exercise and focus on a healthy diet?
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Whether or not you take medications for diabetes, a balanced diet and regular exercise can help manage the disease.
But there’s no need to worry, it doesn’t have to be perfect. “Even a small change can have important implications.” says Marc Jaffe, MD, an endocrinologist at Kaiser Permanente in San Francisco.
“Even if you’re supposed to lose 30 pounds but only reach 10 pounds, things will be different. When your doctor asks you how you’re doing, tell him or her the truth and then set a reasonable goal together.” Mark said.
3. Can you look at your feet?
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“In addition to the standard physical exam, at every visit, the doctor checks my feet.” Josh Berkman, a 43-year-old New Jersey resident, said.
This is because diabetes affects circulation and causes nerve damage, and a cut or other change in the foot can be a precursor to big trouble.
4. Do you smoke?
Whether you’re an old smoker or you’ve always checked “non-smoker” on your medical forms, your doctor will ask you this question.
“If you have diabetes, smoking greatly increases the risk of heart disease and kidney disease, as well as the risk of other diseases.” Wesley said.
If one does smoke, but is not ready to quit, “then be honest.” Mark said. “Doctors will help find certain strategies to at least reduce tobacco use.”
5. How have you been feeling lately?
Feeling stressed, anxious or depressed?
You should tell your doctor. “These symptoms are extremely common in people with diabetes and may even be associated with this disease alone.” Dr. Mark says.
Mental health issues can make it harder to manage diabetes, as well as have an impact on blood sugar and the immune system. Your doctor can show you how you can feel better and provide effective treatment.
6. Is there a weight problem?
Being overweight can make it harder for your body to control your blood sugar and to use insulin (the hormone that controls blood sugar).
If weight loss is needed, it should be discussed with your doctor to get a sense of the best way to start losing weight.
But weight loss can also be problematic, especially if it’s rapid. “At one point, I lost a lot of weight at a very fast pace. But my doctor told me it wasn’t healthy.” Josh said. “Now I know that if you lose 5 pounds or more in a week, something can go wrong and you need to be seen immediately.”
7. What is the condition of the heart?
Diabetes can put you at increased risk for heart disease. Doctors should know the patient’s blood pressure and other markers, such as cholesterol and triglyceride levels, at each visit.
If the doctor doesn’t mention it, the patient should ask proactively to find out what he or she can do to stay healthy.
“My doctor told me that my body needed to produce more, good HDL cholesterol, and that it took exercise to do that, so I started being active.” Josh said.
8. Do I need to change my diet?
Physicians will help patients plan a healthy diet or help connect them with a diet therapist who specializes in diabetes orientation.
Remember that everyone is different, and the foods you need will change over time.
“It took some fumbling and experimentation for me to figure out how certain foods affected me.” Josh said, “I learned that I can eat pizza and pasta in moderation. But potatoes can have a greater impact on my blood sugar. So I had to beware and cut back on eating chips and fries, and only a little at a time.”
9. Are these symptoms normal?
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Blurred vision, thirst, polyuria, rapid weight loss, and mood changes can all be signs of poorly controlled diabetes.
The doctor should be told about all of these symptoms that don’t seem normal or may be problematic.
“Small conditions can also be signs of big problems.” Rifka said.
One way to make sure you don’t forget about these “little problems” at your next appointment is to “write down your questions and concerns ahead of time and bring that piece of paper with you to the appointment.” Mark says.