OHSU

Adults

Seeing an Adult Diabetes Specialist (Endocrinologist)

Woman with pump PT
When you arrive, a medical assistant will greet you, take your blood pressure, weight and pulse, and take you to an examination room. The medical assistant will put the readings from your blood glucose (blood sugar) meter into our computer system so we can keep track of them. We will also check your meter to make sure the dates and other settings are correct. If you have an insulin pump or continuous glucose sensor, we will put this information into our computer.

If this is your first visit to the Harold Schnitzer Diabetes Health Center, your doctor will ask about your health, your family members' health, and your diabetes. Your doctor will examine you, paying attention to areas that might be affected by diabetes. You can talk with your doctor about any concerns you have.

If you are seeing a doctor you have seen before at the Harold Schnitzer Diabetes Health Center, the doctor will talk with you about any health problems or concerns since your last visit. Your doctor will also check the medications you are taking, and talk with you about possible side effects. For your physical examination, the doctor will pay the most attention to areas that could be affected by diabetes.

When we examine or talk with you, we will follow the American Diabetes Association Standards of Care. These guidelines tell your doctor how to monitor your blood sugar (glucose) control, blood pressure control and cholesterol control, and the health of your kidneys, eyes and feet.

At every appointment, we will review the information from your blood glucose meter and from your insulin pump and continuous glucose sensor if you have them. This information, the doctor's examination and things you tell us about your health will help us choose the best treatment for your diabetes. Your doctor may change the medications you are taking, ask you to meet with a diabetes educator or take a diabetes class, or ask you to see another doctor if you need it. Your doctor will also arrange for any lab tests you need, and talk with you about how to keep in touch between doctor visits. If you have a computer with internet access, you can see your test results with the MyChart system. We can also send your test results in the mail.

To Learn More About My Chart

Seeing a Dietitian

When you have diabetes, keeping track of what you eat and drink is very important for managing your condition. Your doctor may ask you to see a dietitian, a health care provider who specializes in helping people eat right to stay healthy. You may ask your doctor about seeing a dietitian if your doctor does not mention it.

First he dietitian will talk with you about your eating habits, and how your eating can affect your blood sugar and other conditions like high cholesterol or high blood pressure. Next, the dietitian will help you create an eating plan. This might include learning about portion sizes, carbohydrate counting, label reading and meal planning for weight loss. You can also learn how to cut down on sodium, trans fats and saturated fat. This will help you control your blood pressure and cholesterol.

Your dietitian can also talk with you about physical activity to help control blood sugar. You can also learn the best way to monitor your blood sugar and the best times for blood sugar testing.

For You and Your Family - Diabetes Education

The Harold Schnitzer Diabetes Health Center has certified diabetes educators who can teach you how to use a blood glucose (blood sugar) monitor or how to start using insulin. If you need an insulin pump or continuous glucose monitoring system, they can help you learn to use them as well.

Using a Blood Glucose Meter

When you have diabetes, it is important to keep track of the sugar in your blood. To do this, you will take a small blood sample, then put a drop of blood on a test strip in a blood glucose meter. The meter will tell you how much sugar is in your blood.

At the Harold Schnitzer Diabetes Health Center, a certified diabetes educator can show you how to use the blood glucose monitor that is best for you. They can also show you how to keep a diary of your blood sugar (glucose) and use this information to stay healthy.

Starting to Use Insulin

If you have Type 2 diabetes, your condition may change over time. To make sure you stay as healthy as possible, your doctor may recommend that you take insulin or change the type of insulin you already take.

After you and your doctor agree to try insulin (or a new type of insulin), the doctor will ask you to see one of our certified diabetes educators. They will talk with you about how your insulin works and show you how to give yourself shots. A diabetes educator can also tell you how to avoid having low blood sugar, and what to do if that happens. You will also learn how to safely dispose of the syringes and needles used for insulin injection.

Using an Insulin Pump

An insulin pump is a small device that looks like a pager. It gives insulin through a small tube (catheter) that is placed under your skin. You can wear the pump on your belt or under your clothing. A computer inside the pump controls how much insulin you receive. The insulin in the pump needs to be changed every three days.

An insulin pump can help control your blood sugar, including when you exercise or do other physical activity. The pump delivers a precise amount of insulin when your body needs it, so you may have low blood sugar less often than if you take insulin from shots. It is easier for some people to wear a pump than to take insulin shots several times each day.

If you and your doctor agree to try an insulin pump, you will see one of our diabetes educators. At your first appointment, your educator will show you the different types of pumps available. You will also see a dietitian to talk about insulin and carbohydrates. Once you have your pump, the diabetes educator will show you how to use it. After this, you can start using your insulin pump.

In the first weeks after getting your pump, you will have your diabetes educator's pager number. If you have any questions or problems, call your diabetes educator right away. Once your pump is working well, your diabetes educator can show you some of its advanced features.

Using Continuous Glucose Monitoring Sensors

Your blood sugar is constantly changing. Foods with carbohydrates and some types of stress cause your glucose level to rise, while insulin and physical activity can make it fall. Checking your blood sugar frequently with your blood glucose machine is one way to understand what affects your blood sugar. Continuous Glucose Monitoring Sensors a new technique for tracking your blood sugar.

Continuous glucose monitoring uses a sensor, a transmitter and a receiver. The sensor is a tiny electrode placed just under your skin, often in your abdomen. The transmitter is about one inch long and one inch wide. It is attached to the sensor. The receiver is a separate device, about the size of a cell phone, that you can carry in your pocket or clip on your belt. The sensor measures glucose levels in the fluid around your cells. This is different from measuring the sugar in your blood. The sensor will measure your glucose level every few minutes during the day and night. It sends this information to the receiver so you can monitor your blood sugar. There are two types of sensor systems - one for people who do not have an insulin pump, and one that works with your pump if you have one. If you have an insulin pump, you will not need a separate receiver.

If you have a glucose sensor, you will still need to test your blood sugar with your blood glucose machine. This is because the glucose sensor needs information from your blood sugar readings. Your doctor will ask you to enter information three or four times each day.

If you and your doctor decide to try a continuous glucose monitoring sensor, you will meet with a diabetes educator. Your educator will place the sensor on you and show you how to use it. Sensor visits usually last 60-90 minutes.

Diabetes Education Classes

At the Harold Schnitzer Diabetes Health Center, we can teach you everything you need to know about diabetes and living a healthy lifestyle. We have classes for people with type 1 diabetes, type 2 diabetes and pre-diabetes.

To Learn More

To learn more about diabetes education classes, call 503 494-8664

For more information about the Harold Schnitzer Diabetes Health Center, call 503 494-3273