Type 2 Diabetes

Type 2 Diabetes

Is it time to refocus?

Type 2 Diabetes Blog

September 29, 2010 

I have a daily routine of actions I take to manage my diabetes.   I check my blood sugar first thing in the morning.  I count the carbs in my breakfast and bolus for them.  I exercise.  These and other actions are so woven into my day that they have become habits that I do without thinking.  And that lack of thought, I realize, can become a problem. 

This past week I spent 4 days with 7 other people with diabetes (PWDs) at a training session.  Despite our attempts to stay focused on the training agenda, our conversations often veered to personal stories about our families and, of course, our diabetes management.  I found myself constantly comparing what I do to what they do.

Kate tests her blood sugar 12 times a day.  “I want to know what is happening,” she said.  I usually check 7 times a day which seems totally lax compared to her 12 times!  In reality I have been checking 4 or 5 times a day for the last few months.  How, I wondered, had I allowed my volunteering, family activities and travel to override my diabetes vigilance without noticing?

Gary just started on the pump and has been very committed to recording in a log book his blood sugar readings, exercise times and amount of carbs eaten. I haven’t kept a diabetes log book since last November when I started on the pump.  My pump and my meter do it all for me; they’re storehouses of information.  My pump tallies up the amount of insulin I take every day and stores the time and amount of my boluses.  My meter records blood sugar readings and allows me to add comments such as before or after a meal or after exercise.  It also provides weekly or monthly averages of those readings.  I rarely look at that information on the machine much less download it to my computer.  Yet, I can remember studying the numbers and words I had written on my blood-smeared, tattered log sheet last year- it was a very useful, tangible record.

At each meal during the training, we all played “guess the carbs” before giving ourselves a bolus.  Does the cup of creamy risotto with cheese have 45 or 60 grams of carbs?  What about this raisin, oatmeal cookie?  Would you say it has 30 grams of carbs?    I think I have ½ a cup of potato salad.  Do you think the carb count is 40, 60?  I must admit that most of the time my guess was on the low end and it gnawed at me.   What a game of Russian roulette we play.   If I don’t know the carbs in the food I regularly eat, how can I bolus correctly?  Perhaps I am lulled by the ease of using the pump to correct any high reading into being careless with judging the amount of carbs in the foods I eat.

Healthy habits are a good thing.  Yet, they’re not when they make us lazy. I realize I need to review my diabetes management plan to ensure I’m not on automatic pilot with my daily habits, that they’re really meaningful and will continue to help me improve my diabetes management and my health. While it may seem a waste of time, taking time to reflect really is an important part of any process. No matter how well things are going, small changes may make what we’re doing even better and help prevent a future problem.

Ask yourself:  Have your habits become too routine? Are you still focused on staying educated about new diabetes research, medicines and treatments?  When was the last time you logged your blood sugars to look for trends? Getting in a rut is so easy.  Take it from me, I know. So let’s commit to reviewing our daily habits and putting our diabetes management first. 

Glamorize your pump!

Type 2 Diabetes Blog

September 19, 2010

What a revolutionary idea – the pump as a fashion accessory!  As one who wears a pump with tubing that frequently gets in a tangle, I am often at a loss of where to put the pump or how to deal with the tubing.

Do I hide the pump in the pocket of my pants or slip it in my bra?  Clip it onto the waistband?  Tuck it into a pouch that can be belted around my middle section?  None of these options are ideal and they often produce a pump bump under the clothing. 

Hanky Pancreas, the genius design of Jessica Floeh, turns the pump into a fashion accessory that enhances the feminine desire to be beautiful, sexy, and playful.  Jessica, who was diagnosed with Type 1 Diabetes at 4 years old, began using an insulin pump at age 21 to gain better metabolic control. Her medical health improved, but she struggles, as many of us with diabetes do, with body image and anxiety over an attached medical device. 

Jessica’s solution is to glamorize the pump and make it visible.  Don’t know where to put the pump when wearing that form-fitting black dress?  Just clip the pump to one of Jessica’s fun designs and wear it in plain view. No longer do I, or you, need to hide the pump or to feel less feminine because a pump is attached to our bodies. 

The pump as a fashion statement moves our thoughts in a new direction – a positive affirmation of ourselves as women… who wear medical devices.  What a paradigm shift!   

Read more about Jessica and her designs at the following sites:




Vitamin D deficiency

Type 2 Diabetes Blog

September 13, 2010

Two years ago my lab report showed my vitamin D level was very low.  I began taking a mega dose of Vitamin D-3 to correct the deficiency and continue to take varying doses based upon my most recent lab work. People with diabetes often have low levels of vitamin D and current research shows that most people are vitamin D deficient.  My husband recently discovered that his vitamin D level was low and began taking a daily supplement.

Vitamin D is important in developing strong bones by helping the body absorb calcium. The September issue of Nutrition Action Heath Letter (published by the Center for Science in the Public Interest) states that one in two women and one in four men over age 50 will break a bone because of osteoporosis.  Maintaining good levels of vitamin D may ensure stronger bones and fewer breaks. The article goes on to say getting enough vitamin D could protect more than bones.  It may lower the risk of colon cancer, heart attacks, and stroke. 

Vitamin D deficiency has been associated with both Type 1 and Type 2 diabetes and with metabolic syndrome (a combination of insulin resistance, high blood pressure, abnormal blood cholesterol and triglyceride levels).  Vitamin D deficiency may be associated with cardiovascular disease, multiple sclerosis and complications of pregnancy. 

The sun is a great source of vitamin D, but with suntan lotion slathered on or staying inside rather than playing in the sun, we often limit our exposure. Good food sources are cod liver oil, fish like red salmon and fortified items such as milk.  Yet, it would be hard to consume enough of these foods to maintain an acceptable level of vitamin D. 

The debate is ongoing as to the acceptable amount of daily vitamin D supplement to take.  The current guidelines recommend 400 International Units (IU) a day from age 51 to 70 and 600 IU over 70.  The new guidelines may recommend daily supplements of 400 to 1,000 International Units for healthy adults under age 50. For adults over 50, supplements of between 800 and 2,000 IU are recommended. 

You may want to include a vitamin D check in your next lab work if you have not already done so.  Talk with your doctor about the lab results and what you can do to maintain a healthy level of vitamin D in your body.   

For more information click here


No Get Away from diabetes

Type 2 Diabetes Blog

August 28, 2010

“We should get away for a few days,” my husband Larry said to me.  And that is just what we did – got away to Lake Lure, NC for a long weekend.  Summer has been unbearably hot and we were lured by the thought of cooler, less humid days in the mountains of western North Carolina.  Surprise – heat, humidity and rain followed us to Lake Lure!  And so did my diabetes.

On the drive over, we stopped in Asheville, NC to eat lunch at the newly opened Antler Hill Village and Winery at Biltmore Estates.  We enjoyed typical pup fare of Fish and Chips at Cedric’s Tavern -named for George Vanderbilt's beloved St. Bernard, Cedric.  Ummmm…how to bolus for this?  Few if any carbs are in the fish, but the breading and the chips have do have carbs, but the fat content is high.  OK, 2.5 units of insulin, set on dual wave bolus (pump talk for giving a little bit now and the rest over a specific time period).   High fat content in a meal will slow down the conversion of carbs into glucose.  The dual wave bolus setting would allow a slower insulin delivery to match the delayed conversion of carbs.

Oh, wait.  We will be walking around the village which should increase my insulin sensitivity.  What to do?  Should I reduce my bolus and let the exercise help keep my blood sugar under control or should I leave the bolus alone and set a temporary basal rate (pump talk for changing the amount of background insulin delivered each hour)?  I decided our walk will be more of a stroll than a power walk and do not change either setting.

Then we toured the village, stopping to learn more about the history of the Vanderbilt’s and Biltmore Estates in The Biltmore Legacy Theater and to browse through a few shops.  Just as we started to leave, rain began to fall.  We ducked under the portico of the Creamery to wait out the summer shower.  Even though only an hour had passed since lunch, I decided to check my blood sugar.  It was 78!

The roller coaster of managing diabetes is real.  Maybe I should have set a temporary basal rate or taken a smaller bolus.  I really don’t know.  Most of what I do to manage my diabetes is based on an educated guess.  I am thankful for that education and realize that most of the time I get it right. It’s just so maddening when I don’t get the expected outcome.

I know that a few glucose tabs (fast-acting carbs) would bring my blood sugar up to around 100 but so would ½ cup of milk so I decided to share a scoop of ice cream with Larry instead.   I don’t recommend eating ice cream as standard treatment to a low blood sugar –high in calories and fat.  But the vanilla ice cream was delicious and creamy – just the best!   We sat at a table under the portico for 15 minutes and I checked my blood sugar again. The reading was 98.  We made a quick dash through the drizzling rain to the Wine Shop to browse and wait for the rain to stop.  With the sun shining, we got in the car and continued to Rumbling Bald Resort, Lake Lure. Diabetes in tow.  


What’s up with that number?

Type 2 Diabetes Blog

August 22, 2010

Exercise lowers blood sugar, right?  Moderate to intensive exercise increases the muscles’ sensitivity to insulin.  The insulin moves the sugar (glucose) in the blood into the muscle to be turned into energy.  For those with diabetes, increased exercise, along with healthy eating, is often suggested as a good way to reduce our high blood sugar levels.  Well, that is not always the case as I recently learned.

I try to be physically active each day – some more than others.  There are the normal activities of housework, yard work, grocery shopping, etc.  I also schedule time for more vigorous activities.  I go to Curves at least 3 times a week, more if possible.  I also do lap swimming at the community center several days a week.

I routinely check my blood sugar before I exercise to be sure I am around 130 mg/dl.  If not, then I take in some simple carbohydrate like ½ glass low-fat milk or several glucose tab.  I usually find that swimming or working out at Curves will lower my blood sugar by 30 – 70 points depending on the intensity of my workout.

Knowing that fact, I check my blood sugar after my exercise activity to be sure I am in a safe blood sugar range before driving home.  If needed, I have with me extra glucose tabs.

Imagine my surprise after swimming when my meter number was 145!  What’s up with that number, I wondered and didn’t think any more about it.  Perhaps it was just a meter glitch or one of those inexplicable events that most of us with diabetes experience from time to time. Well, I experienced the same thing last Friday.  This time the meter reading was 150! 

I am concerned about this turn of events.  I exercise to lower my blood sugar not to increase it!  As I’m just about to begin an internet search about this aberrant reading, I open my email and find my answer or at least a possible answer to why my blood sugar is going up after swimming.

The newsletter from Diabetes Heath had an article “Exercise Often Raises Blood Glucose in Type 1” by Dr. Kris Berg.   Dr. Berg says that strenuous exercise can activate the “flight or flight” response which helps us to meet emergency needs such as completing a race or a vigorous game.  Strenuous exertion requires high-energy expenditure. To meet this requirement, the adrenal gland releases the stress hormones adrenaline and noradrenaline into the blood.  This release stimulates the liver to send sugar (glucose) into the bloodstream at a faster rate than normal.  If this rate exceeds the rate at which glucose is absorbed by active muscle tissue, blood glucose rises.

 I have type 2 diabetes.  I am aware that exercise may cause hypoglycemia (low blood sugar) and was very interested to learn that exercise could raise blood sugar levels. Could this be the explanation for my high blood sugar reading after swimming?  Does strenuous exercise affect PWD 2 as it does PWD 1?  I don’t know the answer to either question. 

I do know that managing diabetes is never simple and that I will continue with my exercise plan, learning to adjust to my blood sugar readings. If you’ve noticed your blood sugar rising after exercise let me know, I’d love to hear your experiences and what you think is going on.


Myths about insulin

Type 2 Diabetes Blog

August 15, 2010

At a recent support group meeting, I was asked why I, a person with type 2 diabetes, choose to inject insulin.  I gave my stock answer: lower blood sugar, lower A1c, and reduced risk of diabetes complications.  While many nodded in agreement, several people were actually shaking their heads in disbelief.  So I asked, “Why would you not want to inject insulin.”   Their responses lead to a great discussion on many of the myths that still surround injecting insulin.  I’ll share the topics we discussed in hopes of reducing any fears or concerns you may have about injecting insulin.

1.    “ Injecting insulin is painful.”  Truthfully, it is not painful.  The very thin, small needle goes into the fatty layer just under the skin where there are fewer nerve endings.  Several people had their syringes or disposable pens with them.  Once the others saw the actually size of the current needles, they were relieved. 

2.    “My diabetes is worse if I have to inject insulin.” Or “I’ve failed in managing my diabetes.”  To answer these concerns, our CDE (Certified Diabetes Educator) reviewed the nature of type 2 diabetes.  She reminded all of us that we need insulin.  Insulin moves the sugar (glucose) in the blood into the cells where it is converted into energy.  Over time our beta (insulin-producing) cells may slow down their insulin production.  If this happens, we can benefit from using insulin to very effectively lower our blood sugar.  

3.    “But my doctor says he will put me on insulin if I don’t do better at controlling my blood sugar.”  How sad that some doctors still use injecting insulin as a threat.  Unfortunately, this scare tactic usually does not result in perhaps what the doctor hopes – that patients will lose weight, be more active or take their oral medications.  In truth, many times doctors present insulin negatively because they themselves don’t quite know enough about it. 

4.    “People who start insulin often get complications.” Diabetes complications come from untreated high blood sugar over a long period of time not from injecting insulin. Yes, some PWD, even some doctors, allow high blood sugar numbers to continue for too long.  The result may be complications from diabetes. So adding insulin to the treatment plan sooner rather than later may lower those high blood sugar numbers and may reduce the risk of diabetes complications. 

5.    “It’s expensive.”  Any treatment plan will cost money.  We discussed ways to reduce the cost of insulin and the supplies used in injecting insulin.  Many pharmaceutical companies have programs to reduce cost.  We suggested talking to one’s doctor and pharmacist about possible other programs that provide financial aid.    

I was happy to be a part of this open, honest exchange of questions and answers and believe our discussion dispelled some of the myths surrounding insulin for those attending the support group. Choosing to inject insulin was right for me.  My blood sugar numbers are consistently in my target range, and my A1c is lower than before I started injecting insulin. I hope sharing this experience will ease some of your concerns about injecting insulin.


Sisterhood at AADE 37th Annual Meeting

Type 2 Diabetes Blog

August 8, 2010

DiabetesSisters was well represented at the AADE 37th Annual Meeting that occurred in San Antonio, Texas, this past week!   Several of our sisters were at this event.  Our founder, Brandy Barnes; DS bloggers, the C3 Sisters: Claire, Connie and Cindi; and DS member, Riva Greenberg.

Brandy has bought her dream for a sisterhood for women with diabetes to reality.  I made many new friends at the first Weekend for Women last May in Raleigh, N.C.  Women of various backgrounds came together to share their diabetes stories and to find support and guidance.  Plans are under way for the next conference. I hope you make plans to attend.

 The AADE meeting is a great place for Brandy to share the mission of DiabetesSisters, to network with others, and to learn what is new in diabetes management.

One of the people I met at the first Weekend for Women is Claire Blum.  Our first connection is being from the same state – Tennessee.   Our second connection is our passion for mentoring others with diabetes and believing that the patient voice is not heard enough by the medical community.  Claire, a CDE, is serving her community well by helping to develop a partnership between medical professionals and diabetes patients for better diabetes management.

Claire, along with Connie and Cindi – the C3 Sisters,( Yin & Yang of Diabetes ) presented  Conversations that Matter: Living With Advanced-Duration Diabetes.  Their 100 + years of ‘Life Lived Well with Type 1 Diabetes’” provided valuable experiences for this presentation.

Riva and I became friends several years ago at a training session for peer mentors.  We are not close in physical location (Brooklyn – Tennessee).  We are close in how we view our diabetes.  We accept it and stay educated about diabetes and current treatment options. We are thankful for the blessings we have received from having diabetes: a healthier body from making healthy food choices, exercising daily and managing our diabetes, many new friends that may live down the street, in another state or on another continent, and meaningful work as we mentors others with diabetes.

Riva has written several books on diabetes, has her own website Welcome to the Diabetes Stories Website and blogs on the Huffington Post She and her husband, Bou, presented Beyond Motivational Interviewing: What can happen when you catch someone doing something right.  The presentation drives home the truth that people already have within them the ability to overcome challenges such as managing diabetes. The idea is to allow people to decide what they can and will do to manage their diabetes without prescribing a preset agenda for them to follow.

I am excited that our sisterhood was part of the recent AADE annual meeting.  I hope they all had a great time.  I am sure they learned so much, and I look forward to them sharing their convention experiences with us very soon.

Educating Family and Friends

Type 2 Diabetes Blog

August 1, 2010

Markee’s June 27th post struck a chord with me.  I have family members and friends who are concerned for me and want to give me, what they think, is good advice.  They mean well, but their statements are not based on current information about diabetes. At first, I was angry and ignored their comments.  I felt that I knew more than they did. I was the one learning about diabetes and creating my management plan.  Now I am more secure in my knowledge of diabetes and my managing of it, and I take the time to educate them.

When family members or friends give me diabetes advice that I know is not correct or appropriate, I ask the person why she believes her advice is right for me.  Once I know the reason for the comment, then I help her understand how I manage my diabetes.

My mother-in-law was often concerned about me eating at specific times and said to me  “Oh, you are on insulin and need to eat at set times don’t you?”  I asked her why she thought I needed to eat meals at set times during the day.  She told me that her uncle had had diabetes, had used insulin and had always eaten at set times. 

I explained to her that the newer insulins didn’t require me to eat at certain times. I told her that I used a long-acting insulin to help my blood sugar stay stable during the night and between meals.  I also used a rapid-acting insulin to prevent the after meal spike in blood sugar regardless of when I ate.  Because I used both of these insulins, I could choose when I ate.  Once I began using the pump, I explained to my mother-in-law that the rapid acting insulin in the pump would continue to help me keep my blood sugar stable and allow for flexibility in meal times. No longer is she concerned about my meal times.

My cousin would often say, “That dessert will run your sugar up.  Let me get you some fruit.”   She thought eating fruit would help me avoid the sugar found in most desserts. Why?, I asked.   She had “heard on TV” that type 2 diabetes could result from eating too many things that were high in sugar. My cousin thought I could control my blood sugar if I ate lots of fruit and avoided desserts and other items that were high in sugar.  I talked to her about the natural sugar in fruit.  I explained that eating fruit would still make my blood sugar go up.  My body did not know the difference in sugar from fruit or sugar from a cookie. 

We counted the amount of carbs from a typical breakfast for her -45 to 50 grams for cut up peaches, blueberries, and strawberries – not counting any other food item she had. My cousin confessed to trying to lose weight and to avoid diabetes by eating large amounts of fruit at lunch and dinner and sometimes for a snack.   Eating fruit instead of cookies, cakes, or pies is more nutritious.  Yet, overloading the body with so many carbs at one time may cause the beta (insulin-producing) cells in your body to work overtime pumping insulin into the blood stream. My cousin realized a healthier approach would be to cut back on the amount of fruit per day.

A concerned friend told me more than once, “Here, eat these crackers, I don’t want you passing out before the meal arrives.”  I asked why she thought I would pass out if the meal was delayed.   My friend related that her sister who has type 2 diabetes would sometimes pass out if she skipped a meal.  I certainly could not explain why this happened to her sister. 

Instead I explained hypoglycemia or low blood sugar to her.  I gave her some of the symptoms of low blood sugar such as feeling weak, being shaky, or not thinking clearly.  I told her that mild hypoglycemia could be treated by eating 15 grams of simple carbohydrates such as 3 of the glucose tabs I carry in my purse or 10 jelly beans or by drinking a glass of low-fat milk or half of a regular Coke.  Now my friend knows what to do if I have low blood sugar and is not as concerned that I might pass out when we are together.

Once I realized the reason for my friends’ and family’s concerns and helped them understand more about diabetes, our relationships have became stronger.  They are comfortable asking me questions about diabetes instead of telling me what I should do.  And I am more open to sharing with them how I manage my diabetes.  I have found that being open and honest with my family members and friends is the best way to gain the support I want, and need, from them.  


An Inspiration

Type 2 Diabetes Blog

July 25, 2010

My friend, who has had type 1 diabetes for 45 years, inspires me to be positive no matter how difficult a situation may be.  His indomitable spirit will not allow his diabetes or his complications – very poor eye sight and severe neuropathy in both feet –  to stop him from living an active life.

My friend loves to fish.  His poor eyesight does not prevent him from baiting his hook and casting the line into the water.  The love of fishing often lures him to local fishing holes, a well-stocked lake 2 hours away and on a 2 week fishing trip in Canada.  Often my friend and his buddies will freeze what they catch until they have enough for a charity fish fry at our church.  They may serve 75 or more people at these events.  Now, that’s a lot of fish to fry!  And I can attest that in addition to being good fishermen they are great cooks.  Our church family looks forward to these events. 

He also likes to hike – not just a mile or two, but up to 8 miles or more in one day.  What a remarkable feat since he has severe neuropathy.  My friend belongs to a hiking club, and he tells us funny things that happen on these hikes – like Mike sitting down in poison ivy.  Or a bear cub darting across their path causing all of them to jump from the trail into the brush, hearting pounding.  During the fall, he likes to hike at least once a week.  How does he manage these hikes even though he has almost no feeling in his feet?  “I just watch where I place my feet,” he says.

Hiking and fishing are just two of my friend’s activities. He spends much of his free time helping others.  He works in our church’s Christian Service Center, filling boxes with food and then carrying them out to a client’s car.  He and his wife will drive others in need of a ride to their doctor appointments or to the grocery store.  Whatever the task, he is willing to help in any way he can.

We have been friends for the last 10 years and it has only been in the last 3 years that I have known he has diabetes.  It is not something he talks about.  My friend is not ashamed of having diabetes.  He just refuses to use it as an excuse to not do something.  He told me that when he was diagnosed as a young man, he decided that he would live an active life and manage his diabetes and that is exactly what he is doing.

 I admire his can do attitude and his active lifestyle.  My friend inspires me to stay focused on managing my diabetes well, reducing my risk of complications.  His example challenges me to be physically active, to enjoy life, and to help others along the way.  I am thankful for his friendship and his positive example.

May you have such inspiration in your life or better yet, you be the inspiration to others. 



Partnering with your health care provider

Type 2 Diabetes Blog

July 18, 2010

I have found that managing my diabetes is not a solo act – and it works better that way.  As the person with diabetes I do have the most control over many decisions and have learned that with the support of others such as my family, friends, and doctors or, to be inclusive of all medical professionals, my HCPs - Health Care Providers, I do a better and more consistent job in managing my diabetes.

Creating a partnership with my HCPs has become important to me as I try to understand the current research on diabetes and how it relates to me and management of my diabetes. This partnership encourages me to be proactive in managing my diabetes and helps me have less fear about possible future diabetes complications.  The topic of creating a partnership between HCP and patient is not new – just do a “google” search and the results are overwhelming.  Yet it is very relevant to me, a person with a chronic illness who wants to live a healthy, active life.

 I am glad to see that this topic was a part, albeit it small part, of the events surrounding the American Diabetes Association’s 70th Scientific Sessions that occurred in Orlando, FL, June 24-29, 2010.  Dr. David Marrero, Professor and Director of the Translation Research Center at Indiana University, spoke to about 35 HCPs, sharing possible obstacles in the way they conduct a patient visit that could prevent their patients from participating as partners with them.  Yes, there are so many things that HCPs do or don’t do that can create a barrier between them and their patient such as checking their watch frequently or using difficult to understand medical terms.  But I believe we are not responsible for the actions of our HCPs.  We are accountable for our actions during our visits with our HCP such as being truthful in our answers or taking our daily logs.  And maybe our actions will inspire our HCPs to become our partners in managing our health.

Even though I have had a good relationship with my “doctors,” I was not committed to the idea that I was in charge of managing my diabetes or my overall health.  When I was diagnosed with diabetes in 1994, I allowed my HCPs to direct my treatment plan.  I did not know another person with diabetes and did not attend any support group.  I did not talk about diabetes or even try to educate myself on this disease.  In 2005, that changed.  Oral medications were not controlling my blood sugar so I decided to use insulin to bring my blood sugar down into my target range. 

While learning about insulin and how to inject it, I met, for the first time, people with diabetes who are managing diabetes well and living very healthy, active lives.  In talking with these new friends, I discovered that they educate themselves about diabetes and ways to treat it by reading books, magazines, different blog sites, and medical sites.  They talk to other people who have diabetes, and they learn how their bodies respond to different foods, medications, and stress.  Best of all, they go prepared to visits with their HCP to discuss what they have learned and how to better manage their diabetes.  They are partners with their HCPs in managing their health.

I want to be a person who manages her diabetes well and discusses the management of this disease with my HCPs.  While I do make sure I have a list of current medications and my meter so information can be downloaded, I want to share with you one action I have taken that helped me create a partnership with my HCPs – and may help you too. To help me participate better in the typical 15 minute office visit, I created an Agenda for each visit, which included these topics.

1.    “Latest lab work.” I have my lab work done before the visit and have my own copy so we can go over it together.  

2.    “Review of last visit”.  We review what we had discussed and what action we had taken and decide if further treatment is needed.  Or if I was referred to a specialist, we discuss the report from the specialist.

3.    “Reason for current visit.”  This is my opportunity to bring up a new problem/situation or to ask any questions about new medications or treatments.

4.    “Prescriptions to be renewed.”

5.    “Notes.”  Here I write all the new instructions, appointments, referrals, lab work requests, samples or definition of new terms.  This notes section is so important to me because now I do not leave the office without getting the samples, or scheduling the lab work or asking the important question. 

Now my HCP and I have a tangible record of what we said during this visit for future reference. 

Because I have used an Agenda for the last several years with all my HCPs, they know I am serious about managing my diabetes and my overall health.  Now I find that my HCPs will share new medications and treatment plans for me to consider.  Then we discuss the options for treatment and many times I make the final decision which option I will pursue. 

As patients there are many things we can do to bring about a productive partnership with our HCPs.   If you have a great partnership with your HCPs and would like to share a tip or two with the rest of us, please add a comment to this blog.  In sharing our “best practices” for communicating with our HCPs, we can encourage each other in our quest for better understanding and managing of our diabetes and our desire to work in partnership with our HCPs.