Should Stable Type 2 Diabetes Patients Continue Visiting Medical Centers?

Do patients with stable type 2 diabetes still need to continue follow-up visits at a medical center?

Hello Doctor, I apologize for the interruption! I would like to ask you a question.
I have been living with type 2 diabetes for over seven years.
After discovering this issue during a health check, I have been receiving treatment at a medical center.
Initially, I was on oral hypoglycemic agents, and now I am on medications for glycemic control.
My hemoglobin A1c levels have been maintained between 5.6 and 5.8.
I visit the clinic every three months for medication refills and blood tests, and I have annual eye and foot examinations.
The doctor has informed me that my condition is well-controlled.
Recently, due to adjustments in the national health insurance system, a physician friend of mine (not a family medicine or internal medicine specialist) suggested that since my condition is stable, I could transfer my care to a general family medicine or endocrinology clinic, or to a clinic participating in a diabetes shared care network.
They mentioned that as long as I consistently take my medication, my condition can be managed, and the clinic would be able to prescribe medications.
This would also help conserve national health insurance resources and reduce healthcare costs.
Additionally, they noted that patient data is now interconnected, so if any serious issues arise, I could simply be referred back to a hospital.
However, I found that most clinics do not perform blood tests or eye examinations.
I am not very familiar with this process, and based on my past experiences, I have often addressed common issues related to ophthalmology, dermatology, and otolaryngology at clinics first.
If the clinic lacked the necessary equipment or could not manage the issue, they would then refer me to a larger hospital.
Given that diabetes is a chronic condition requiring regular follow-up, I would like to seek your advice on this matter.
Thank you.

Yang, 30~39 year old female. Ask Date: 2022/03/18

Dr. Li Jian reply Internal Medicine

If blood sugar levels can be consistently controlled, it is recommended that you transfer to a primary care medical facility for management.
It is best to choose a facility that has a physician specializing in metabolic disorders or one that is part of a diabetes collaborative care network.

Reply Date: 2022/03/18

More Info

When considering whether stable Type 2 diabetes patients should continue visiting medical centers, there are several factors to take into account. Based on your situation, where you have been managing your diabetes effectively for over seven years with a stable HbA1c level between 5.6 and 5.8, it is reasonable to consider transitioning to a primary care physician or a specialized diabetes clinic, especially if they are part of a diabetes care network.

1. Stability of Condition:
Your diabetes management appears to be stable, which is a crucial factor in deciding whether to continue with a specialized medical center. Regular monitoring of your blood glucose levels and maintaining your HbA1c within the target range indicates that your current treatment plan is effective. If you are consistently achieving these results, transitioning to a primary care provider or a diabetes clinic could be appropriate.

2. Availability of Services:
While it is true that many primary care clinics may not offer the same level of specialized testing (such as regular blood tests or eye exams), it is essential to ensure that the clinic you choose has the capability to monitor your condition adequately. Look for clinics that have healthcare providers experienced in managing diabetes, such as endocrinologists or family medicine doctors with a focus on chronic disease management. They should be able to provide you with the necessary prescriptions and monitor your condition effectively.

3. Cost and Resource Management:
As you mentioned, transitioning to a primary care setting can help reduce healthcare costs and alleviate the burden on the healthcare system. This is particularly relevant in light of changes to health insurance policies. By utilizing community resources, you can still receive quality care while contributing to a more sustainable healthcare model.

4. Regular Monitoring:
Even if you transition to a primary care provider, it is crucial to maintain regular monitoring of your diabetes. This includes periodic blood tests to check your HbA1c levels, as well as annual eye exams and foot checks to prevent complications. You may need to schedule these tests at a medical center or find a primary care provider who can facilitate these assessments.

5. Communication and Follow-Up:
Ensure that you have a clear communication plan with your new healthcare provider. Discuss your medical history, current medications, and any concerns you may have. It is also essential to establish a follow-up schedule to monitor your condition and make any necessary adjustments to your treatment plan.

6. Emergency Situations:
In the event of any complications or if your blood sugar levels become unstable, it is important to have a plan in place for referral back to a medical center. Your primary care provider should be able to refer you to a specialist if needed.

In conclusion, if your diabetes is well-managed and you have access to a competent primary care provider or diabetes clinic, transitioning from a medical center may be a suitable option. However, it is vital to ensure that you continue to receive comprehensive care, including regular monitoring and access to necessary tests. Always prioritize your health and well-being, and do not hesitate to seek specialized care if your condition changes or if you have any concerns.

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