Roles of health professionals on a diabetes care team

Your primary care doctor (usually an internist or a family medicine doctor) is responsible for the day-to-day medical management of your diabetes and may coordinate your diabetes care. A nurse practitioner, nurse educator, or physician assistant also may coordinate your care.

Your health professional will help you find the right oral medication and possibly insulin to regulate your blood sugar (glucose) level. He or she also will help you adjust medications as your diabetes changes. For this reason, it is very important that you notify your health professional if your symptoms change.

Most primary care doctors are excellent at managing diabetes. However, if your symptoms worsen or you develop complications, you may need to see a specialist-a doctor who has additional training in a particular field. You should see some specialists, such as an ophthalmologist and podiatrist, regularly; these specialists provide care to prevent eye and foot complications from diabetes.

Other specialists, such as cardiologists (heart specialists), nephrologists (kidney specialists), or orthopedic surgeons (bone, muscle, and joint specialists), are seen only when a specific complication arises. For most people with diabetes, it is important to see these specialists at least once a year so they can monitor the complication.

Roles of specialists

Team member	Specialty	Role	How often seen
Endocrinologist	Endocrine system	Treats complex cases of diabetes with difficult-to-control blood glucose levels	Sometimes regular visits, or as treatment problems arise, such as you cannot stay within a safe blood sugar range and hemoglobin A1c levels are higher than desired
Nephrologist	Kidney	Treats complications related to kidney failure	As kidney problems develop
Ophthalmologist	Eye	Monitors your eyes for diabetes complications and treat any vision problems	Regularly, at least once a year
Cardiologist	Heart	Treats complications related to the heart and circulatory system	As complications arise
Neurologist	Brain	Treats brain and nerve disorders, such as strokes and diabetic neuropathy	As complications arise
Podiatrist or orthopedic surgeon	Foot	Helps you monitor your feet and treats any complications, such as foot ulcers	As needed for foot problems. Have your primary care doctor examine your feet once a year.

Other health professionals on a diabetes care team

Other health professionals that may be involved in your diabetes care include:

• Mental health professional. Many people with chronic diseases suffer from depression. A psychiatrist, psychologist, or social worker can help you deal with the mental challenges associated with living with diabetes. In addition, one of these specialists can help you learn to manage stress, which can affect your glucose control.
• Exercise physiologist. Physical activity is an important part of your treatment for diabetes, so you may want to work with an exercise physiologist to develop an appropriate exercise program for your fitness level. Exercise physiologists have experience working with people who have varying levels of strength and aerobic capacity. An exercise physiologist can help you devise strategies for sticking to your exercise plan.
• Registered dietitian. Your diet plays a key role in keeping your blood sugar levels within a safe range. A registered dietitian has training in nutrition and experience developing meal plans and helping people make changes in their lifestyle. Changing your eating habits may be the hardest thing for you to do to care for your diabetes. A registered dietitian can help you take small steps toward the overall goal of a balanced diet.
• Nurse educator. A nurse educator helps you understand your diabetes and its treatment. Having diabetes is a lifelong challenge, and as your disease changes and progresses, your nurse educator can provide the information you need to adjust and change with it. He or she may also coordinate your diabetes care.