Why It’s Important to Ask Questions About Diabetes
Diabetes is the 5th most common chronic condition in the US. According to the National Council on Aging, nearly 1 in 4 people aged 65 years and above have type 2 diabetes.
Insulin is a hormone secreted by the pancreas. When your body converts the food you eat into glucose, insulin helps move the glucose from your bloodstream into cells, where it remains as stored energy until your body needs it.
Type 2 diabetes is a condition where your body doesn’t respond to insulin as it should, or it doesn’t produce as much insulin as it needs.
If you or someone you know has diabetes, here are 11 questions you should ask your doctor.
- What type of diabetes do I have and what does that mean?
The ‘type’ of diabetes matters because it guides treatment and long-term care.
- Type 1 diabetes: Your body makes little or no insulin. This is an autoimmune condition, and people who develop it may be born with a genetic risk for it. It can show up suddenly, at any age, although it is most often diagnosed in childhood, adolescence, or young adulthood.
- Type 2 diabetes: Your body either doesn’t make enough insulin, or doesn’t properly use the insulin it does make (a condition called insulin resistance). This is the most common type that affects people aged 65 years and up.
- Prediabetes: Your blood sugar is consistently higher than it should be, but not high enough for diabetes. It doesn’t mean you will definitely get diabetes, but it does put you at high risk if you don’t take cautionary measures.
- What should my A1C and daily blood sugar targets be?
A1C (also called HbA1c or glycated hemoglobin) is a blood test that shows your average blood sugar over the past 2-3 months. Most adults aim for A1C under 7%, but your doctor will set your personal number based on your health.
If you’re managing your diabetes well, A1C tests twice a year are plenty. If not, you may need to test every 3 months. Always ask your doctor for a clear number to aim for.
- What lab tests do I need and how often?
Regular diabetes tests catch problems early. Some common tests your doctor may order are:
- A1C: Every 3 months until stable, then every 6 months.
- Blood pressure and cholesterol: At least once a year.
- Kidney checks (eGFR and urine albumin): Once a year.
- Eye exams: Once a year.
- Foot exams: Once a year if feet are healthy, more often if ulcers or gangrene are spotted.
Click here to find doctors near you, who can help you manage diabetes
- What medicines will I need and what are the likely side effects?
Common medications for diabetes include metformin, newer pills like SGLT2 inhibitors and GLP-1 receptor agonists, and insulin. Side effects vary from none to stomach upset, low blood sugar, weight gain or loss, and urinary infections.
Always ask your doctor:
- Why they chose the medicine for you.
- How to take the medications and when to call for problems.
- If less expensive or generic option exists.
Learn more: What are out-of-pocket costs in Medicare
- Could my medicines cause low blood sugar?
Yes, it is possible. Insulin and some pills can cause low blood sugar or hypoglycemia. This is a dangerous condition that often shows up as:
- Shakiness, trembling, or shivering
- Sweating
- Confusion
- Fainting
- Falling
Hypoglycemia can be fatal. Ask your doctor how to time meals and medicines to prevent low blood sugar. Keep emergency sugar on hand (juice, candy, regular soda, glucose gel). Call 911 if severe symptoms occur.
- How will diabetes affect my heart, kidneys, eyes, and feet?
Over time, high blood sugar can damage blood vessels and nerves. This is called diabetic neuropathy, and it raises your risk of heart disease, kidney problems, vision loss, and foot ulcers.
Your doctor may want you to get annual kidney and eyes tests, and will have you perform daily foot checks for blisters and sores.
- Should I meet with a dietitian, and will Medicare cover it?
A large part of managing diabetes involves eating the right foods, in the right amounts. A registered dietitian can create a safe, realistic meal plan that fits your tastes and is compatible with your medications.
Medicare covers medical nutrition therapy if you have diabetes or kidney disease. Ask your doctor for a referral to a dietitian or diabetes self-management education program.
- What vaccines and preventive care do I need?
Diabetes can be a gateway to several other illnesses and infections. Staying up to date with vaccinations recommended for people aged 65 years and above helps keep you out of hospital.
Recommended vaccines include the yearly flu short, pneumococcal vaccine for pneumonia, COVID-19 vaccines when advised, and shingles shots.
Read more: What happens if you don’t, or can’t, pay your hospital bill
- What diabetes supplies and devices will I need, and does Medicare cover them?
Common diabetes supplies include:
- A home blood glucose monitor, also called a glucometer
- Testing strips for the glucometer
- Insulin
- Insulin-administering syringes, pens, or pumps
Medicare covers many diabetes supplies. Part B or Part D may pay for insulin and related supplies. Glucose monitors may be covered if you meet certain conditions.
Speak to a staff member at your clinic, and they should be able to connect you to a knowledgeable, trusted, and licensed Medicare adviser who can review your current benefits and see what more you may qualify for.
- How can I stay active safely and what kind of exercise should I do?
In many cases, diabetes is strongly linked to weight. But even if losing weight is not the goal, exercise helps use up your body’s energy stores, improves strength, and aids balance and mood.
Walking, chair yoga, water exercises, and lifting light weights are all great options. Ask your doctor to design an exercise plan for you based on a level of activity safe for you, and the condition of your heart and lungs. Also ask how to avoid or handle low blood sugar during and after exercise.
Check out 9 exercises for better balance
- What warning signs should make me call my doctor, or go to the emergency room?
Seek immediate, urgent medical attention if you notice:
- Shivering, shaking, confusion, and fainting. These point to hypoglycemia.
- High fever, shortness of breath, chest pain, or severe weakness.
- A new sore on your foot, skin redness, pus, or a wound that won’t heal.
- Signs of ketoacidosis (nausea, breath that smells fruity, and rapid, gasping breaths).