Nobody likes going to the doctor. Usually we're going either because we're too sick to do anything more worthwhile, we've gotten to an age where certain "uncomfortable" exams are necessary, or we partied a bit too hard and woke up with neither memory nor clothing.

Despite all of these things, I think that the hardest part of going to the doctor is choosing one in the first place. Unless you have a friend or coworker that can recommend theirs, chances are you're going to have little or no idea what he or she is like until your first appointment.

Here's what you should look for during your first appointment:

1. Is this somebody that you can be honest with? Your doctor is going to find out the most about you not through examination but through your statements. Sure, your blood type, gender, height, weight, blood pressure, and lack of functioning pancreas are all pretty obvious by looking at you or doing simple tests. However, some of the most important factors influencing your health are pretty much impossible for your doctor to find out from a couple sporadic visits. Does your family have a history of heart disease? Are you sexually active? How often, and how much, do you drink? Do you smoke cigarettes? Do you abuse marijuana, cocaine, prescription drugs, or any other kind of drug? You should not be embarrassed telling this to your doctor. He or she is not there to pass judgment on you, but to help you survive and live a healthy life. This is absolutely imperative. If you feel like you can't tell these things to *anyone*, then you need to reassess how you're living. I am sexually active (though monogamous), I binge drink occasionally, I don't use any of the drugs listed above, and my doctor knows this.

2. Does your health insurance cover this doctor? Although this seems to be strictly financial on the surface, there are definitely health ramifications. There are a couple reasons your insurance might not cover this doctor: if you have an HMO, he or she may be "out of network", or your insurance may consider your doctor's practice a hospital visit. If this is the case, a routine appointment for a cold or the flu could set you back over a hundred dollars. For comparison, no matter what I see my doctor for, I am responsible for only a $10 copay.
How does this affect your health? Simply put, the more expensive it is to visit your doctor, the less you will go. You'll think, "Is it worth $150 to find out if this is strep throat or just a cold?" and more than likely you'll decide that it isn't. Money shouldn't factor into your healthcare (although apparently a lot of political candidates think it should) so choose a doctor that you can afford to see often without causing you financial stress.

3. Is this doctor okay with you having a separate endocrinologist? I *strongly* encourage all diabetics to see an endocrinologist that is an expert in diabetes; the details of that deserve a whole separate article. However, it is very important to make sure that your primary care physician (also known as GP, or General Practitioner) is okay with you seeing an outside doctor for your diabetes care. I was lucky enough to find a doctor that even encouraged it, asking me unprovoked during our first appointment whether I had an endocrinologist yet. It may be an ego issue, a control issue, or just a trust issue that makes some doctors uncomfortable...whatever it is, make sure your doctor doesn't have a problem with it.

4. Is the doctor overbooked? This is probably the easiest to tell without actually having to see the doctor in person. When you call to schedule your "new patient physical", do they ask you what your schedule is like next week, or next April? When you're sick, you need to see a doctor soon; while a waiting list may make a doctor seem popular, it can keep you from getting antibiotics or other health care in time and may mean this is not the doctor for you.

Choosing the right doctor is not easy. Look at it like a job interview; it will be a long relationship, and sticking with a doctor that is wrong for you doesn't help you, and definitely doesn't help the doctor. Be open, be honest, and if the answer to all the questions above is "Yes!", odds are you've found a great doctor that will help keep you healthy for a long time.

I find that there are a lot of small things that, if you get in the habit of doing them, makes living with Diabetes much easier. Sometimes these habits are so simple and straightforward that they seem like no-brainers, but put into action they have a profound effect.

Doing a blood test right before bed is a good way of getting 7 hours of good glucose numbers easily. Odds are good that if you are a good number when you go to sleep, and your basal rate is correct, that you will wake up an equally good number. Despite this, late-night lows are impossible to totally avoid (as you know if you've read this site, they are one of my "tough spots" with Diabetes). By keeping three things on your bedside table, you can make nighttime much easier and low-stress:

1. Blood test kit. By remembering to bring this to the bedroom when you go to sleep, it is easy to do a bedtime blood test. Also, if you wake up in the middle of the night you don't even have to get out of bed to see what your BGL is.

2. A low. Preferably some kind of candy that doesn't go stale quickly (Starburst or Skittles are two of my favorites.) This way, if you wake up low in the middle of the night, you don't have to take a dangerous walk to the kitchen to get sugar into your system. Try to avoid juices since it's easy to knock the glass over and make a mess. If you have juice that comes in sealed plastic bottles, that'd be perfect.

3. Insulin and a syringe. If you wake up having to pee and you're thirsty, do a blood test since you're likely high. If you need to dose to correct your BGL, both needle and insulin are right there, saving you another trip to the fridge.

I love little tips like these that you pick up over the years of being a diabetic. I'm to the point now where I can roll over in the middle of the night, do a bloodtest, and never wake up more than halfway. The power of simple habits continues to amaze me.

When transitioning to an insulin pump from injections, by far the most foreign concept is that of a cord connecting something in your pocket to something that is inside you. After a couple of days, the strangeness went away and now there are even times where I couldn't tell you which side of my body my site is.

However, there are sinister forces working against the beautiful pairing of person and pump, and foremost among these is the doorknob. The first question a lot of people ask about the infusion set is, "Does it hurt when you take it out? What if it gets ripped out?" After taking a moment to let the wave of sarcasm inside me subside (No, there's a tube inside of me, and even though most people complain about taking off A BANDAID, it feels great when the tube gets torn out!) I tell them that it hurts surprisingly little.

If you're not on the pump, or if you're on the pump but have never had a site accidentally come out, you should know that it hurts surprisingly little. It's definitely not comfortable, but is only slightly more uncomfortable than the aforementioned bandaid. The most painful part, of course, is that now you have to put a new site in. I've probably had a site pulled out six or seven times in the roughly two years I've been on the pump. Every time except for one has been because of a doorknob.

This is the situation that I want you to avoid, because it has happened way too many times to me: It's the middle of the night, you have to pee, and you stumble to the bathroom half-asleep. You have no idea where your feet are stepping, let alone where your pump cable is. And as you step through the doorway, you feel a tug on your hip and see your pump cable hanging from the doorknob. This is one of the times where syringe-users have it easier. In this situation, pump-users, I want you to shake your head a little, blink your eyes a couple of times, and wake up just a bit before walking to the bathroom. Sure, it will take you roughly 74 milliseconds longer to fall asleep once you're cozy back in bed, but this is far better than having to wake up all the way so you can insert a brand new site.

Doorknobs are evil. They are simple and overlooked, and they are jealous of your smart, cherished pump. They will lurk on their doors, trying their hardest to look innocent, but give them one teensy inch of looped pump cable and they will exact their jealous vengeance. It has been six months and counting since my last "doorknob incident", so maybe I've learned my lesson; hopefully now that you're warned you can avoid such incidents of doorknob rage altogether.

If your endocrinologist appointments go anything like mine,you've heard"Diabetics have to take special care of their feet!" about a hundred times. Although mostly associated with older or long-term diabetics, even young Type-1ers like me have to be careful.

Now, add even more support to that argument. New research is showing that by using an infrared thermometer, diabetics can check for "hotspots" on the bottom of our feet. Areas that are abnormally warm can be a sign of tissue breakdown, a precursor to ulcers. Finding the damaged tissue early and resting for a day or two can give the tissue time to heal before becoming a full-blown wound.

Insurance coverage is spotty, but more and more doctors are writing prescriptions for the $150 gadgets. Even more promising, new technology is being developed to function like a bathroom scale; stand on it every morning, and it will automatically test multiple locations and warn you of any high temps. Not only will this be easier than hand-held units, it will make it possible for the elderly or very overweight to check their feet as well.

I personally won't be purchasing one yet, but am glad that some very good medical minds are paying close attention to a very real, very dangerous long-term risk to us diabetics. If such a thermometer sounds like something you'd like, talk to your doctor! He or she will let you know if it's a good fit for you. And speaking of good fit, be sure to keep following the standard preventive care on your feet: where good-fitting shoes and regularly check your feet for redness, lumps, and cuts.

For the third year in a row, I have had to adjust the level of insulin I take to follow drops in temperature. Since I live in northern California, it isn't snowing or anything, but the interior temperature of my apartment is around 54 in the wintertime as opposed to 74 or higher in the summer.
While one would usually assume that a seemingly-minor 20 degree difference in temperature wouldn't affect blood glucose levels, once again this year my overnight BGL's have dropped along with the thermostat. Sunday night I woke up at around 3 AM with a BGL of 63; Monday, around 4 AM at 75; and last night again, around 4:30 AM at 68.

How can I prevent this from happening? Three years ago, it meant moving from one Lantus injection per day to an injection in the morning and a smaller dose in the evening. Now, the pump makes it easy by allowing me to create a custom dosage rate between midnight and 5AM during which I only receive 85% of my usual basal rate. I'll have to be rigorous about doing a blood test when I wake up to zero in on the proper custom rate, but these late-night hypoglycemias are wrecking me sleep pattern.

Of course, this may not happen to you or the diabetic you love, but it is something to keep in mind. Keeping your blood test kit and some form of sugar on your bedside table also helps reduce the impact such "Late-Night Lows". As for me, I'll see how this custom rate goes and throw another comforter on the bed.