Primary care physicians and patients also must look beyond seasonal snacks and stressors to long-term teamwork.
When it comes to proper diabetes management, the importance of the primary care physician's (PCP) role cannot be overstated. The routine check-ins and tests that primary care physicians provide are crucial to keeping people with diabetes – whether they have type 1 (T1D) or type 2 (T2D) – as healthy as possible.
The holidays can be an incredibly challenging time for managing diabetes. Keeping carbohydrate intake balanced and regularly taking one's medication are tasks that get jumbled up into the myriad of "must do's" that happen during the holidays. Traveling, hosting parties, and the abundance of sugary goodies surrounding people with diabetes during the holiday season all contribute to their having a tough time staying on track.
PCPs can be the best source of support for people with diabetes during challenging times like the holidays. Lately, however, a critical shortage of PCPs has placed roadblocks in the way of the PCP/patient relationship; a shortage of 54,000 to 139,000 physicians forecasted by 2033 could significantly affect the ability of diabetics to manage their chronic illness long-term.
To address the PCP shortage that the United States currently finds itself in, diabetics should seek out a team approach to their diabetes management. A team approach can be beneficial during the holidays if members of the care team are out of the office or otherwise unavailable. A capable care team that includes not only the PCP but specialists like endocrinologists and nutritionists allows for diabetics to obtain comprehensive care for all their needs.
In medically underserved places such as rural areas, a team approach may be challenging to achieve. There may be only a few specialists in the area, or the PCP shortage may have already started to make an impact.
By maintaining regular contact with diabetic patients and the extended team, PCPs can foster this team approach to diabetic management. Technological advancements such as electronic medical records (EMRs) and telehealth capabilities can also help facilitate this relationship.
The PCP can be the first point of contact and the main source of valuable information and advice for a patient with diabetes. They may have even been the source of the diagnosis, so they have a perspective that started from the very beginning of the diabetic's journey.
The guidance PCPs provide during the holiday season can be invaluable and help a diabetic traverse the challenging time and come out without any adverse health issues or emergency room visits, which see an uptick during the holidays. When patients lack access to a primary care physician, they may rely on the emergency room even more.
In addition to abundant carb-heavy foods and stressful situations that come with the holidays, there are other challenges that people with diabetes may face that PCPs can help them navigate. For example, the regular eating schedule that is often crucial to a well-managed diabetic diet may be difficult to maintain during the holiday season. Alcohol consumption can also rise, and physical activity may be hard to come by when a person's mind is preoccupied with holiday budgets and schedules. PCPs can try to connect with their diabetic patients before the hustle and bustle of the holidays kick into full swing to give them some tools to use when things become challenging.
Diabetes affects about one in 10 Americans, and one in three Americans are considered to be prediabetic. These numbers mean that diabetes and prediabetes can be a significant part of a PCP’s job. With the PCP shortage looming, the pressure may be on current and emerging primary care doctors to approach diabetes in novel ways and be proactive caregivers.
Both T1D and T2D are multifaceted conditions with a lot of considerations for patients and physicians. Those considerations and possible issues are taken to a new level during the holiday season. By recognizing that the role of the PCP is integral to proper diabetic management and being as proactive as possible, primary care physicians can help their diabetic patients enjoy the holidays and enter the new year as healthy as possible.
Ahmet Ergin, MD, FACE, is an endocrinologist who completed his fellowship training through the Cleveland Clinic. He is founder and CEO of SugarMD, which uses a combination of patient education, pharmaceutical intervention, medical intervention, and herbal and vitamin supplements to help patients manage diabetes.