Living with type 2 diabetes requires having a solid team to manage your care. While your primary care physician is your first line of defense, you may also see an endocrinologist on a regular basis “to optimize diabetes control, guide you with lifestyle changes, and monitor for any potential complications,” says Eiriny Eskander, MD, an endocrinologist at Diabetes and Endocrine Specialists in Encino, California.
That said, it isn’t always easy to establish a rapport with specialists. Appointments can be hard to come by and often feel rushed. You may also feel frustrated if their recommendations don’t work as well as you’d hoped. So how can you feel more in the driver’s seat of your care when some things are simply out of your control?
“Be forthcoming about your goals, anxieties, and concerns,” says Dr. Eskander. “Being open and starting a conversation is vital to ensure you and your doctor align.”
Here are a few questions to bring to your next appointment to help you and your provider get on the same page — and, ultimately, better manage diabetes together.
1. Do My A1C Goals Need to Be Adjusted?
You may assume you should follow standard guidelines, which recommend keeping your A1C below 7 percent if you are not pregnant and do not have frequent hypoglycemia (low blood sugar). But your doctor may have a more individualized plan in mind.
[1]
“We sometimes have different goals for different patients, depending on age or other medical conditions,” says Eskander. The American Diabetes Association’s standards of care state that healthcare professionals should take each patient’s health profile into account and determine the best A1C goal for them.
[2]
For younger and otherwise healthy adults, that may mean striving for an A1C much lower than 7 percent. For older adults or individuals who, with their provider’s guidance, have determined that stringent glycemic control poses more harm than benefit, a higher A1C may be acceptable.
[2]
Ask your doctor if your A1C goals should be adjusted based on your specific health status and needs.
2. What Can I Do to Improve My Sleep?
Ask your endocrinologist how you can improve the quality of your sleep, and share whether you experience any sleep disturbances. This is especially important, because getting poor sleep can increase cortisol (stress hormone) levels, as well as blood sugar, says Komal Patil-Sisodia, MD, an obesity medicine specialist and founder of Eastside Menopause & Metabolism in Redmond, Washington.
“It’s estimated that up to 87 percent of people with type 2 diabetes have sleep apnea,” says Dr. Patil-Sisodia.
[3]
Be sure to tell your provider about symptoms such as daytime sleepiness or excessive snoring, as they may order a sleep study to screen for sleep apnea.
3. Am I Measuring My Blood Sugar Enough?
According to the American Diabetes Association, many healthcare providers don’t think it’s necessary to routinely self-monitor blood glucose levels if you’re effectively managing diabetes with diet and exercise or with medication that doesn’t increase your risk of hypoglycemia. But if you do take medication that increases that risk, such as insulin, meglitinides (nateglinide, repaglinide), and sulfonylureas (chlorpropramide, glimepiride, glipizide, glyburide), your healthcare provider has likely recommended regular self-monitoring.
[4]
[5]
Regardless of which bucket you fall into, it’s always worth checking in with your provider about your glycemic control regimen. If they don’t think daily monitoring is necessary, you can still ask how often you should check your blood glucose levels and if there are specific reasons — diet, exercise routines, medications — that checking more regularly would make sense.
[6]
4. How Can I Better Manage Stress?
“Patients should be asking questions around how to manage high stress levels,” says Patil-Sisodia. “For those who have high stress leading to depression or anxiety, counseling and other treatment can be very helpful.”
An endocrinologist can make recommendations on therapists or psychiatrists. They can even suggest other methods of dealing with mental health concerns. For example, Patil-Sisodia recommends participating in mindfulness activities, such as meditation or breathing exercises, to decrease cortisol.
[7]
What’s more, research indicates mindfulness practices can help people with type 2 diabetes improve glycemic control.
[8]
5. Should I Monitor for Any Diabetes-Related Conditions?
Type 2 diabetes can cause a number of complications, ranging from vision changes and nerve damage to kidney disease and other chronic conditions. Eskander recommends talking to your doctor about these risks, given your current health profile. This will help you figure out if you’ll need to adjust your management plan and expand your care team to include a cardiologist, nephrologist, ophthalmologist, or other specialist.
Feel in Control of Type 2 Diabetes
Managing type 2 diabetes can be challenging, but having a solid care team — especially an endocrinologist you trust — can make a difference. Asking them all the right questions can help get you to your health goals faster, so take a few minutes to think about and write down your questions ahead of time. Then, bring them to your next appointment to kick off a productive discussion with your provider.
The Takeaway
- Endocrinologists play an important role in managing type 2 diabetes, including making lifestyle recommendations and monitoring coexisting conditions and complications.
- Asking thoughtful, treatment-focused questions at your next appointment can help you build a rapport with your endocrinologist and establish a better care plan.
- Talking with your provider about A1C goals, glucose monitoring, sleep, stress, and complications from diabetes can help you fine-tune your treatment plan.
