If you have diabetes, help is always at hand. Find out more, take charge, ask for help, Aslena Hussain, Diabetic Society of Singapore Diabetes Nurse Educator, explains who's who in your Diabetes Health Core Team.

To achieve the best possible diabetes care, you need to work together with healthcare professionals. Understanding your diabetes and taking charge of your condition will help you delay diabetes-related complications and improve your quality of life. Members in your healthcare team include
 

• You
• General Practitioner/Endocrinologist
• Diabetes Nurse Educator
• Dietitian
• Ophthalmologist
• Podiatrist
• Social worker, psychologist / psychiatrist
• Other medical specialists
 

You
Effective diabetes care is normally achieved by team work, between you and your diabetes care team. Jugging your daily activities, medical appointments, family obligations and work commitments requires a lot of effort but it will be well worth the time and energy.

Your diabetes care team is there to support you. Ask questions and request more information especially if you are uncertain or worried about your diabetes and/or treatment. Remember the most important person in the team is you.
 

Some tips to take charge of your diabetes include

• Learning and practising self-care - e.g. diet, exercise and monitoring blood glucose levels

• To examine your feet regularly or have someone check them.

• Knowing how to manage your diabetes and when to ask for help if you are ill, e.g. chest infection, flu or diarrhoea and vomiting

• To communicate regularly with your diabetes care team and ask questions you may have

• To make a list of questions to ask during appointments

• To keep your scheduled appointments and inform the diabetes care team if you are unable to do so

• Manage your time effectively to prevent burn-out

Family Doctor/General Practitioner
Your primary care provider, who may be your general practitioner, is the one you see for your general checkups when you fall sick. He or she may also refer you to specialists or other team members such as an endocrinologist. An endocrinologist is a doctor with special training (and usually certification) in diseases such as diabetes.

Never miss your doctor's appointment or self-medicate.

 

Diabetes Nurse Educator
A Diabetes Nurse Educator is a registered nurse (RN) with special training and background in caring for and teaching people with diabetes. Many are certified in the field of diabetes. In Singapore. Diabetes Nurse educators undergo formal training at Nanyang Polytechnic. Thereafter they will sit for an examination to be a certified diabetes nurse educator (CDE). Nurse educators are well equipped to help you with the day-to-day aspects of diabetes self-care.

They can answer your questions on the following and more:
• What is diabetes?
• How do I cope with diabetes?
• What can you tell me about diabetes medications?
• How do 1 use insulin?
• How do I overcome my fear of the needle?
• How do I keep track of my diabetes control through monitoring of sugar levels?
• What are the symptoms of low blood glucose?
• What are the symptoms of high blood glucose?
• What should I do when I fall sick?
 

Dietitian
A dietitian is trained in nutrition. Dietitians help figure out food needs based on your desired weight lifestyle, medication, and other health goals (such as lowering blood fat levels or blood pressure). A visit to the dietitian is helpful even for those who have had diabetes for many years. Our food requirements change as we grow older.

You may wish to ask questions about the following.

• How do I have a balanced diet?
• How do I read food labels?
• How can I manage my weighty
• How do I make individual meal plans?
• What happens when I eat out and attend special events?
• How do I make food substitutions?

For advice on food and nutrition, turn to Dear Dictation.
 

Ophthalmologist
Diabetes can affect the blood vessels in the eyes. When eye problems are caught early, you need not have to suffer irreversible complications.

Under the recent clinical practice guidelines (June 06) from the Ministry of Health, Singapore, it is recommended that every person with diabetes has his or her eyes checked by retinal photography at least once a year.

These checkups are the best way to detect diabetic retinal eye problems. If there are changes, the doctor will treat the problem or refer you to another doctor with special training in that area.
 

Podiatrist
A podiatrist Is a health professional who is trained to treat problems affecting the feet and lower limbs.

With diabetes, you are prone to poor blood flow and nerve damage in the lower limbs. You may get infections more often too. Sores, even small ones, can quickly turn into serious problems, if left untreated. Foot sores or calluses need to be checked by your primary care doctor or a podiatrist. Do not try to fix these yourself, because the problem could lead to a serious infection. Please inspect your feet for signs of foot problems.

Podiatrists treat corns, calluses and more serious problems. It is recommended that you have your feet screened for complications at least once a year.
 

Social Worker/Psychologist/Psychiatrist
Living with diabetes is not lust a medical problem. You may also need emotional support and guidance. This is where mental health professionals such as social workers, psychologists and psychiatrists come in.

Social workers may be able to direct you to the right resources to help you with your medical or financial needs. Some social workers may also provide assistance in other areas, such as problems within the family or at your workplace.

A clinical psychologist can counsel you and your family and help you work through the stress of living with diabetes. A psychiatrist is a medical doctor who can prescribe medication to treat physical causes for emotional problems. Check out the article  Get off the Right Foot.
 

Dentist
People with diabetes are at a greater risk for gum disease. This is because the excess blood sugar provides the right environment for bacteria, which can lead to an infection.

Visit your dentist at least once every six months and notify your dentist that you have diabetes. See The Sweet Tooth on dental care.

Exercise Physiologist
No matter what type of diabetes you have. you cannot run from the fact that you need to exercise. Exercise is the key to lowering blood sugar, helping your body use insulin better, and helping you control your weight. Exercise can also help to improve your blood fat levels, reduce stress, and increase your overall fitness level. Never use diabetic complications as an excuse not to exercise. There are still many safe exercises you can do. Turn to Quit Resisting!

An exercise physiologist is the best person to help you plan your fitness program because he or she is trained in the scientific bass of exercise. You will still need to make sure that you have your doctor's approval before you embark on any exercise regimen.

Below are some ups to get your diabetes on track.

Diabetic Society of Singapore offers Diabetes self-care education and counselling as well as screening tests at highly subsidied rates at three of our DSS diabetes education and care centres.

DSS SERVICES

Screening for complications:
• Blood tests for HbA1c (glycated haemoglobin) for blood sugar control and cholesterol

• Retinal Photography

• Podiatry Service and Foot Screening for Feet At Risk

• Urine test for Microalbuminura

Specialised Care:

• Podiatry Service - available at all our 3 centres every Saturday afternoon by appointment.

• Advanced Dietary Counseling by dieticians on alternate Saturdays by appointment.

Support Group and Counselling:
Support groups for the elderly. adult and youth.
 

Telephone support and help line

tel. 6450 6132 Ang Mo Kio;

tel  6564 9818 Jurong:

tel. 6398 0282 Boon Keng

DSS at Ang Mo Kio Hospital
Ang Mo Kio Hospital
17 Ang Mo Kio Avenue 9 #02-12
Singapore 569766
Tel : (65) 6450 6132

        (65) 6450 6142
Fax : (65) 6553 1801

South-West Diabetes Education & Care Centre
Blk 528 Jurong West St 52

# 01-353
Singapore 640528
Tel : (65) 6564 9818

        (65) 6564 9819
Fax : (65) 6564 9861

Central Singapore Diabetes Education & Care Centre

Blk 22 Boon Keng Road

#01-15
Singapore 330022
Tel : (65) 6398 0282 Fax :

        (65) 6398 0275