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The diagnosis of diabetes is made under many different circumstances, for example, during a routine medical examination for insurance purposes or during out-patient or in-patient care for other conditions; but most people first learn that they may have diabetes from their family doctor. What happens next varies. Some family doctors continue to provide all aspects of care for their diabetic patients; others refer them to a specialist with an interest in diabetes working on his own or within a hospital clinic. Some family doctors share the care of their diabetic patients with hospital diabetologists, or run their own mini-clinics.

Even if you are looked after by a diabetologist, it is still important that your family doctor knows what is going on as far as your diabetes is concerned. In Britain, and in many other countries, it is the family doctor who is called to your home in the middle of the night when you feel ill, whether your diabetes is the cause of your symptoms or not. Your family doctor cannot look after you properly if he or she does not have all your health details. Most diabetologists or diabetic clinics write to the family doctor every time a patient is seen. Some have cooperation cards kept by the patient on which clinical and laboratory details are written at each visit. If you have such a card, make sure that it is kept up to date and keep it safe and easy to find. If you have out-patient record cards of any sort, keep them where you can find them easily and take them with you whenever you see any doctor, or if you have to be admitted to the hospital.

Whatever arrangement you follow for your diabetic care, it is important that you and those caring for your health are clear who your diabetes adviser is: You must know who you should contact if you need help. You also need to know how to do this during office hours and at night or weekends. If you are unsure about this, clarify it with your family doctor and your diabetologist (if applicable) immediately. You should have on your diabetic card the name, address and telephone number of the person to be contacted in an emergency. Do not wait until three o’clock in the morning on a national holiday to find you have not got them.

When you first discovered that you have diabetes you needed a lot of help and advice. As you became more independent and confident, your contacts with your adviser probably became less frequent. You may have lost touch altogether. But no one ever stops learning about diabetes and even the most careful and expert people with diabetes occasionally need help. It is important that wherever you are, there is a doctor or diabetes specialist nurse whom you can contact if you are having difficulties, or for regular reviews.

You and your adviser may be together for many years, so it is important that you build up a trust and are able to get along reasonably well. Medical and paramedical staff is human and vary in their attitudes and their approach to problem solving and patient care. One doctor’s manner and personality may suit one person but not another. It takes time for you to get to know your adviser and for him or her to get to know you. If, after a time, you really feel that you are not getting along, discuss your feelings with him or consider asking if you can see someone else.

Another factor that may influence your choice of adviser is the framework within which he works. For example, some people prefer to be seen in small local centers, others like to go to large teaching centers. Some just like to see the doctor, others to see all the different specialized members of the health care team. You may not be able to choose exactly what you want, especially in country areas, but if you are unhappy with any aspect of your care and do not ask whether there is an alternative you will never find out about it!

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DIABETES