Dear Dr. Edelman,
My endocrinologist of 20 years just retired. I have my first appointment with a new doctor in a couple of weeks. How can I best prepare?
Dr. Edelman: Since there are different therapies and treatments for type 1 and type 2 diabetes, I’m going to break this down into two sections:
How to Prepare for Your First Appointment with a New Doctor If You Have Type 1 Diabetes
Here are the important things to bring with you, or know ahead of time:
- A brief history of your diabetes, such as when you were diagnosed and what your current degree of control has been (i.e. A1c, time in range, etc.)
- A list of the diabetes devices you use, such as an insulin pump, CGM, blood glucose meter, etc. with a summary of the most recent results (glucose levels, a snapshot of the CGM download, etc.)
- If you’re on an insulin pump, know your settings, including basal rate, insulin-to-carb ratio, and insulin sensitivity factor
- A list of medications you’re currently taking that pertain to your diabetes (names and dosages) including the type of insulin and dose you’re on. If you’re on mealtime insulin, share how you calculate the dose (carb counting for example)
- A list of any other medications you’re taking (names and dosages)
- A list of any complications you have pertaining to your eyes, kidneys, nerves, and heart
- Your weekly exercise routine, including the type of exercise you do, the frequency, duration, and intensity
- A general idea of what you eat in a typical day
- Any recent labs your provider may not have access to
- Lastly, you’ll want to share any major concerns you have – no more than three!
How to Prepare for Your First Appointment with a New Doctor If You Have Type 2 Diabetes
Here are the important things to bring with you, or know ahead of time:
- A brief history of your diabetes, such as when you were diagnosed and what your current degree of control has been (i.e. A1c)
- A list of medications you’re currently taking that pertain to your diabetes (names and dosages)
- Any diabetes medications you tried that didn’t work for you or you had difficulty with
- A list of the diabetes devices you use, such as an insulin pump, CGM, blood glucose meter, etc. with a summary of the most recent results (glucose levels, a snapshot of the CGM download, etc.)
- Any medical problems specifically relating to high blood pressure, abnormal cholesterol, heart disease, and body weight
- A list of any other medications you’re taking (names and dosages)
- Any other medical conditions you have
- Your weekly exercise routine, including the type of exercise you do, the frequency, duration, and intensity
- A general idea of what you eat in a typical day
- Any recent labs your provider may not have access to
- Lastly, you’ll want to share any major concerns you have – no more than three!
You can send a copy of the above information to your doctor’s office before your appointment, but also bring a copy with you to your first visit. Keep in mind…a doctor may or may not have time to look at what you sent ahead of time, but it’s great information for them to have on file, and it’s important information for you to have as well.
Oh and one last thing…and this may be the most important tip of all. When you meet a doctor for the first time, bring a gift…like a box of chocolates! That will go a long way. Seriously!
Check out the following articles for more tips on making the most of your doctor’s appointments:
Top 10 Tips on How to Make Your Doctor’s Appointment a Success
Thank you for the wonderful work that you do.
How fortuitous is this question. I have a number of private practice clients with diabetes who are in this position in which their beloved endocrinologist is resigning from clinical care.
From a practical perspective, your recommendations are great!
Yet, I also want to propose another recommendation for the PWD when planning to meet a new endocrinologist. And that is the interpersonal goodness of fit between a PWD and new endocrinologist.
It could be helpful for the PWD to think about what he/she/they needs or expects from the new endocrinologist and treatment team. The patient could consider what worked and what didn’t work with the previous endocrinologist and treatment team. For example, did the PWD have prior bad experiences with providers about which the new endocrinologist would benefit knowing? Such reflections could prove to be valuable contributions to the discussion between the PWD and endocrinologist when they first meet/build their working relationship. Or, it could help the PWD decide that it will not be a good patient provider fit, and to continue looking.
In fact, I would encourage a PWD to “shop around”for a new endocrinologist. If possible, the PWD could consider meeting with a few endocrinologists before deciding with which endocrinologist to work. (Notably, I’m in an urban area with multiple medical centers with diabetes clinics so this would be easier to do).
It can be empowering for a patient to know that he/she/they ultimately can make such a choice. As opposed to the PWD being told “to just go see Dr. So n So”. By the PWD making that choice, it could also diminish that power differential that occurs in healthcare (be it real or imagined) between, in this case, the endocrinologist and the PWD. The PWD may actually experience him/her/themselves as being an integral part of the diabetes treatment team. And, hopefully, this can facilitate the PWD’s trust and increase the PWD’s engagement in safe diabetes self-management.
(Written at the end of the work day on an iPhone so difficult to express myself clearly and to edit!)
You expressed yourself perfectly! And very good suggestions if, as you said, there are multiple provider options available. Thanks for mentioning the interpersonal element!
Alison Ward, PHD did a great job expressing how patients have the right to choose who treats them. I went through a rough period, after my Endocrinologist that treated me for over 40 years, retired. I found the personal touch has been replaced by clinics and many doctor’s having to stare at their laptops instead of the patient. Eventually, I found an amazing doctor who respected the fact that I’ve had T1 for longer than she has been alive. My question to her, was Why did you become an Endocrinologist, knowing you could make more in other fields? Her response, was I wanted to be good at what I do, and being a GP or other fields didn’t allow her to be an expert. I ‘m thrilled I found someone who respects my experience and works with me and is there for me. On a personal note, she is pregnant and her due date is my birthday. Karma?