Diabetes Management: Be Proactive and Healthy

Diabetes Care|Mar.12, 2020

You've inquired with family members, consulted friends and even looked up patient reviews online. Now, it's time to step into the endocrinologist's office for your health check-up.

Sometimes, people get anxious at the thought of meeting an endocrinology expert, especially if they've been diagnosed with diabetes. However, regular visits to the endocrinologist are essential for effective diabetes management.

While diet, lifestyle and medication are crucial for managing hormone and sugar levels, regular consultations with an endocrinologist are an important aspect of diabetes management. Hormones and blood sugar levels work in many ways to govern our mood and health, so it's super important to keep them under scrutiny.

Knowing a little more about when to see an endocrinologist, what questions to ask and what tests the doctor may prescribe will help you prepare for these visits.

When to See an Endocrinologist

If you've been recently diagnosed with a hormonal imbalance or diabetes, consult an endocrinologist and understand what lifestyle changes you need to make. If you've been living with diabetes for a while, regular visits to the endocrinologist are still important, more so if you struggle to maintain normal blood sugar levels with medicines.

An endocrinologist will check your blood sugar levels, medication, and lifestyle to chalk out the best treatment plan. If you have diabetes, look out for these signs, and visit an endocrinologist if you have:

  • Sudden blood sugar fluctuations
  • Tingling sensation in hands and feet (due to nerve damage)
  • Sudden weight changes
  • Vision problems
  • Kidney disorders
  • Frequent hospitalisations because of diabetes
  • Episodes of hypoglycemia

Ask your doctor to schedule periodic visits for tighter blood sugar monitoring. They may recommend a quarterly or biannual visit, depending on your levels.

How Should I Prepare for My Visit?

When you make an appointment, you may be asked for your recent blood sugar reports. These will help decide the treatment plan and medication/insulin doses.

If high blood sugar levels have been recently diagnosed, your doctor may prescribe additional blood sugar tests (including fasting blood sugar, random blood sugar, and glycosylated haemoglobin [HbA1C] tests).

What Will the Doctor Want to Know?

Your endocrinologist will delve into your:

  • Family medical history
  • Personal medical history
  • Blood sugar readings
  • Diet
  • Physical activity
  • Smoking and alcohol consumption pattern
  • Current medications
  • Abnormal signs and symptoms, if you have any
  • Stress/anxiety

Make a list of these beforehand so you don't forget critical details.

What Will the Consultation typically Involve?

The endocrinologist will thoroughly check the skin on your hands, feet and the inside of your mouth for sores, infections and bruising. They'll also check your heart rate, pulse rate, and blood pressure levels while examining your abdomen.

If you're overweight/obese, your endocrinologist will note your weight, waist and hip circumferences, and blood parameters for future comparison. They may give you a diet plan and exercise regimen to tackle your sugar irregularities. The doctor may ask you to keep a close watch on your blood sugar levels using a home monitoring device if your sugar levels fluctuate a lot and need constant supervision. This will also help you understand your body's sugar regulation trends and help you avoid foods or habits that hamper effective diabetes management.

Learn and ask about newer monitoring tools

Regular monitoring is the cornerstone of good blood sugar control. Flash glucose monitoring and continuous glucose monitoring are currently the most advanced and efficient monitoring methods available for blood sugar monitoring.

Flash glucose monitoring involves a small sensor that you wear directly on your skin. Whenever you want to check your levels, just swipe the reader over the sensor to get the previous 8 hours' blood sugar level and sugar level trend. This monitor checks the amount of glucose in the fluid around the cells of the body (the interstitial fluid). The glucose levels in this interstitial fluid tend to lag behind the blood glucose levels by around 5 minutes, more so if you've been exercising/eating just before the measurement. So, if you and your doctor are planning to change the dose or type of medicine, use the finger-prick or conventional blood sugar test method.

Continuous glucose monitoring is done using a small device worn just beneath the skin. It keeps measuring your blood sugar level continuously all the time, and it even alerts you about too-high or too-low levels. This monitor measures sugar levels every few minutes and charts a graph of your overall sugar level trends.

Two types of continuous glucose monitoring can be done. The first type lets you check your sugar levels in real time and gives you the option of downloading them. However, the second type doesn't give you a live feed; you can only download the results and get retrospective data.

While a flash monitor can be used for up to 14 days without changing, a continuous monitor needs to be changed every 7 days. Like the flash monitor system, the continuous monitor also checks the sugar levels in the interstitial fluid, so a treatment change should only be based on a finger-prick or blood test result.

Know about your focus areas

Experts have agreed that the glycaemic pentad should be the focus area for anti-diabetic therapy. This pentad involves fasting plasma glucose (FPG), postprandial glucose (PPG), HbA1c, glycaemic variability, and quality of life (an individual's perception of their position in life in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards and concerns). A good eye on these parameters will help you streamline your efforts and rein in your sugar levels.

While it's natural to be a little overwhelmed with a diabetes diagnosis, remember that diabetes is completely manageable. The thousands of people happily living routine, active lives with diabetes are proof of this. With the right treatment and lifestyle hacks, nothing can stop you from being the master of your health and getting the most out of life.

Your endocrinologist can be your best friend and partner in diabetes management. In addition to discussing the technical details of your health condition, feel free to share your experiences and questions. Your doctor will be happy to help resolve your doubts and ease your mind, because this is an important part of the healing. A happy mind leads to a healthy body!

Disclaimer: This publication/article/editorial is meant for awareness/educational purposes and does not constitute or imply an endorsement, sponsorship or recommendation of any Products. Please consult your doctor/healthcare practitioner before starting any diet, medication or exercise.