Test Your Knowledge

There are many aspects to becoming an effective self-advocate for diabetes care. Some general guidelines will help patients keep their treatment plan on track. They include:

• Learn as much as possible about diabetes. Patients who understand how diabetes is affecting their health (including all possible symptoms and complications) can work better with health professionals to keep track of the condition and to identify the cause of symptoms.

• Choose a physician carefully. Patients should find physicians who have insight into diabetes care and who can recommend other specialists when necessary. Endocrinologists specialize in treating diabetes and other disorders of the endocrine system. Ideally, patients will choose a lead physician who works with other specialists to provide a “team care” approach to treating diabetes. Members of this team might also include:
  
  
• Certified diabetes educator or nurse educator
• Registered dietitian
• Ophthalmologist
• Dentist and dental hygienist
• Pharmacist
• Exercise physiologist
• Specialist physicians as needed
• Therapists (physical, occupational, speech, psychological) as needed

Patients should make sure all of these professionals are sharing notes and information that is relevant to the treatment plan. Ask them to forward notes to each other, and be sure to get the necessary clarification if different providers offer conflicting advice. To protect patients’ privacy, medical professionals will have guidelines about how, when and to whom medical records may be shared. Patients will need to fill out forms to allow release of their records.


• Select the best, most flexible insurance plans. Whenever possible, patients should choose insurance coverage that allows them the flexibility to see all the physicians required and get the care they need.
  
  
• Be active in the treatment plan. Patients are their own best advocates. They should read and learn the care recommendations and guidelines provided by reliable sources, and by agencies and organizations such as the National Institutes of Health, the Centers for Disease Control and Prevention and the American Diabetes Association. Then, they should ensure that their physician and health insurance provider are willing and able to provide such services. If not, patients should consider changing insurance plans and/or physicians.
  
  
• Do not take “no” for an answer. When an insurance company refuses to pay for a service, patients should write to the company and explain why the service or procedure is necessary. It may help to include research that supports the case and a note from the physician about the necessity of the service. In addition, it may be necessary to explain that paying for coverage of a test or procedure now may help prevent the need for insurance to cover more expensive care later.
  
  
• Be prepared to pay some out-of-pocket expenses. Increasingly, health insurance companies are either cutting back on the services they cover or passing on a larger share of the cost burden to patients. Patients should be ready to pay for some aspects of diabetes care, including education and visits to experts who are not in the insurance provider’s network. There may be other sources of financial support available to eligible patients, such as Medicaid or financial assistance from governmental or private agencies.