Diabetes Care at Home in St. Louis

What diabetes follow-up involves

Diabetes is managed over years, mostly by you, with a clinician checking in at regular intervals. Those check-ins look at blood sugar patterns, medications, blood pressure, kidneys, eyes, nerves and feet.

When getting to an office is hard, visits get skipped and small problems go unseen. Diabetes care at home in St. Louis brings the check-in to you. A Gateway clinician sees you where you live, and Gateway handles scheduling, records and communication around the visit.

What a clinician reviews

The treating clinician decides what each visit covers. Diabetes follow-up commonly includes:

Home blood sugar readings or glucose monitor data, including any lows
The A1c, a blood test that reflects average blood sugar over the past two to three months
Medications, including how insulin is stored and used
Blood pressure and weight
Kidney tests on blood and urine
A foot exam that checks skin, nails, pulses and feeling
Whether a dilated eye exam is due

Our page on lab and imaging coordination explains how tests ordered by the clinician are arranged.

Why diabetes and foot wounds are linked

Over time, high blood sugar can damage the nerves in the feet, so a blister, a pebble in a shoe or a burn from hot water goes unfelt. Diabetes also raises the chance of narrowed arteries in the legs, which cuts the blood supply skin needs to repair itself. And high blood sugar makes it harder for the body to fight infection.

The result is that a small injury can become a diabetic foot ulcer before anyone notices. Good follow-up will not prevent every wound. It does find loss of feeling, poor circulation and skin changes early, when there are more options.

When a wound is already there

A foot wound changes the priorities. The wound care clinician assesses the wound, takes pressure off it and watches for infection. The primary care clinician works on blood sugar, because high readings can slow healing and an infection can push readings higher still.

Gateway’s diabetic foot care coordination keeps wound notes, lab results and medication changes moving between them, and to podiatry or vascular specialists when the clinicians involve them. The guide on managing diabetes during wound recovery describes what to expect during this period.

Daily habits your clinician may ask about

None of these replaces the advice your clinician gives you.

Looking at both feet every day, including the soles and between the toes. See our guide to daily foot checks.
Wearing shoes or sturdy slippers, even indoors, and feeling inside shoes before putting them on.
Eating regular meals with enough protein. The page on nutrition and healing explains why this matters for skin repair.
Having a plan, written by your clinician, for sick days and for low blood sugar.

If you have lost feeling in your feet, do not trim thick nails or calluses yourself. Ask who should do it.

What Gateway arranges

Your treating clinician manages diabetes care and makes medication decisions. Gateway coordinates:

Primary care follow-up at home or in your facility with a Gateway clinician, where available
Contact with your existing primary care physician or endocrinologist, who stays in charge of your diabetes care
A connection to a practice if you do not have a primary care clinician
Wound care visits when a foot or leg wound is present
Records, lab orders, supplies and updates among the care team and family

Coverage depends on the treating provider, your plan and the care needed.

Changes to report and when to call 911

Call your clinician promptly about:

Any new blister, cut, sore or dark spot on a foot, even if it does not hurt
Redness, warmth, swelling, drainage or odor
A foot that changes color or temperature
Blood sugar readings that stay well above or below your usual range
Fever, vomiting or being unable to eat or drink

Call 911 if someone with diabetes is confused, very drowsy, cannot be woken, has a seizure, has chest pain or has trouble breathing. Gateway is not an emergency service. See the guide to diabetic foot ulcer warning signs for more.

How to start

Call 314-325-0126 or send the request care form with a name and phone number only. You do not need a referral, and family members can call.

Tell us who manages your diabetes now, so we can keep that clinician involved.

Common questions

Can diabetes really be followed at home?

Much of it can. A clinician can review readings and medications, check blood pressure and examine your feet in your home, and blood and urine samples can often be collected there. Some things, such as a dilated eye exam, still need a specialist’s office. Availability depends on your location, care setting and the treating practice.

Will the visiting clinician change my insulin or other diabetes medications?

Only the clinician responsible for your diabetes care makes those decisions. If you have an existing physician or endocrinologist, that clinician stays in charge, and concerns from a home or wound visit are sent to them. Ask your clinician what to do when readings run high or low.

How often should someone with diabetes have their feet examined?

Your clinician sets the schedule based on your risk. People with normal feeling and circulation are often examined once a year. People with numbness, poor circulation, a foot deformity or a past ulcer are usually examined more often. In between, look at your own feet every day and call about anything new.

My father has diabetes and lives alone. What should I watch for?

Look at his feet when you visit, or ask someone who sees him regularly to do so. Notice whether he is eating regular meals, taking medications as prescribed and keeping supplies stocked. Watch for new confusion, unsteadiness, weight loss or sores he has not mentioned, and report concerns to his clinician.

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.

Diabetes care at home in St. Louis.