Diabetes and the Primary Care Physician

The number of patients identified with diabetes is growing every year. For every patient diagnosed with type 2 diabetes, there are numerous people with type 1 diabetes and pre-diabetes who go undiagnosed. Early detection of the disease and initiation of treatment can make a huge difference the outcome for the patient. The primary care physician plays a key role in this step.

The Primary Care Physician

Detecting the signs of pre-diabetes or diabetes early can enable your primary care physician to work with you in slowing the progression of the disease. This can vastly lower your risk for diabetes related health complications.

Primary care physicians identify patients at risk for diabetes based on family history and other factors. Member of certain racial ethnicities are more likely to present with the disease. Patients, who have a history of cardiovascular disease, are obese or overweight, and even those with a sedentary lifestyle are at a high risk for diabetes.[1] Pregnant women are screened for gestational diabetes. In addition, patients with certain symptoms will be screened for diabetes.

Diagnosis by the Primary Care Physician

The first step in treating a patient suspected of having diabetes is proper diagnosis. If your primary care physician suspects you have diabetes he or she will recommend a plasma glucose test. The most common tests are the two hour postprandial glucose test and the fasting plasma glucose test.[2]

Once your doctor has the test results, the physician will meet with you. If the results are positive for diabetes, you will begin the journey of learning about the disease, how to manage the disease, and what lifestyle changes you will be making. Your primary care physician will guide you through this journey.

During your initial ‘diagnosis meeting’ with your primary care physician you may be overwhelmed. This is not unusual. You physician will be giving you quite a bit of information, and your emotions will be fighting to take over! It is an excellent idea to come to this meeting prepared with questions and a friend or family member for support.

Treatment

Your primary care physician will create a diabetes management plan designed just for you. This plan will take into account your lifestyle, your weight, your activity level, your age, the severity of disease, your dependence of medications, and more.

If you are diagnosed as a type 1 diabetic you will be taking insulin to help control your sugar level. If you are diagnosed as a type 2 diabetic, you will most likely begin managing your diabetes with lifestyle and diet changes. In some cases, a physician will ask a patient to implement lifestyle and diet changes for a period of approximately six weeks before beginning any medicine protocol. After the six weeks are up, the patient will have another blood glucose test to see if there are any positive changes in his or her blood glucose levels. These results will help the primary care physician determine whether or not to start the patient on diabetes medications.

Team Approach

If you are diagnosed as a diabetic you can expect to visit with your primary care physician at least once every three months for a checkup. The visits may be more frequent during the first months of your diagnosis as you establish a self-management routine.

You should also expect to meet with other doctors who treat diabetic patients. Your primary care physician may refer you to specialists who focus on certain aspects of the disease and will help prevent the progression of the disease.[3] These specialists include:

  • Podiatrists
  • Endocrinologists
  • Diabetic Educators
  • Pharmacists

Your Role in Your Success

You will play a big role in the successful management of your condition. Your physician will be asking you to make lifestyle and diet changes. It is critical that you make these changes immediately and stick to them. Often, the changes are simple and will improve your overall health.

Let’s look at two common changes your primary care physician may ask you to make:

  • Diet: Your diet must change in order to keep your blood sugar from spiking. You will be eating less sugary foods. In addition, you will be eating fewer ‘bad carbs’. Your physician may recommend seeing a dietician to devise a meal plan that includes healthy meals and snacks that fit your lifestyle.
  • Exercise: Exercise is important for diabetics because it helps control weight and helps keep blood flowing to limbs. Your physician will be asking you to exercise every day.

Your primary care physician is your first line of defense in the successful management of your diabetes. It is important to work with your physician and your health care team to create a self-management plan.

References

[1]  Type 2 Diabetes Mellitus: Practical Approaches for Primary Care Physicians. (n.d.). Retrieved from Journal of American Osteopathic Association: http://www.jaoa.org/content/111/5_suppl_4/S3.full

[2] Ibid

[3]  Interdisciplinary Team Care for Diabetic Patients by Primary Care Physicians, Advanced Practice Nurses, and Clinical Pharmacists. (n.d.). Retrieved from Clinical Diabetes Journal: http://clinical.diabetesjournals.org/content/29/2/60.full

[4] This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.