When your primary care physician diagnoses your diabetes, they'll likely suggest a series of lifestyle changes that can make the condition easier to manage, but you'll probably also be referred to an endocrinologist.
In this article, we'll break down what endocrinologists do and their role in treating diabetes.
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As the name suggests, an endocrinologist is a doctor who specializes in the endocrine system. This system is responsible for producing hormones, which are created by different glands around your body. Different parts of your body use hormones to communicate with one another.
Endocrinologists start by checking your insulin and blood sugar levels. Insulin is a term well associated with diabetes, but most people don't realize that insulin is a hormone. When a healthy body has too much blood sugar, insulin is produced to tell the body that it needs to use or store the extra blood sugar.
Someone with diabetes either doesn't produce enough insulin or is resistant to its effects. In both situations, diabetes is essentially a disease of the endocrine system.
An endocrinologist will use their knowledge of this system to determine your insulin and blood sugar levels and put you on a treatment plan that will help your body properly process extra sugar. Because this often involves giving you additional insulin beyond what your body makes, their expertise is important in getting your levels of this hormone correct.
As mentioned earlier, your primary care doctor can diagnose your diabetes. Depending on the type and severity of your diabetes, they may be able to treat your condition by advising you to make diet and lifestyle changes. Should your diabetes not be treatable with those changes alone, your primary care doctor may recommend that you visit an endocrinologist.
You do not need a referral from your primary care doctor to visit an endocrinologist, however. If you feel you aren't getting adequate care from your doctor or simply want to educate yourself as much as possible about what's happening in your body, you can visit an endocrinologist on your own.
Before seeing an endocrinologist, it's helpful to talk to your insurance company to see what medical devices are covered and if they have any preferences for how you receive your insulin. There are a variety of insulin pumps and blood glucose monitors on the market, so you'll want to know what is and isn't covered to allow for a more informed conversation with the endocrinologist.
This is especially true with insulin prescriptions, as some insurance companies prefer you to request refills of a certain length, say, every month or every three months.
Your endocrinologist will have plenty of questions for you. They'll likely ask you about the lifestyle changes that you've already made in an effort to get your diabetes under control and what effect those had. The better you can explain to them what has and hasn't worked for you, the better they'll be able to formulate an effective treatment plan.
This is a good time to ask any questions you may have. It can be a good idea to write these down as they occur to you and bring them to your appointment, so you don't forget any.
The initial visit will be the most involved one. The endocrinologist will get to know the specifics of your condition, what has and hasn't worked so far, your blood sugar levels, and more. If needed, you'll be given a prescription. Because insulin needs to be injected, they'll go over exactly what you need to do should you require insulin.
After the initial visit, the endocrinologist will ask you to make regular follow-up visits. These will be less involved and will mostly consist of the doctor checking to see how well your body is responding to treatment and making any adjustments that may be necessary.
Diabetes is often managed by an entire care team. In addition to the endocrinologist, the care team may consist of several other specialists. Which of these specialists you'll end up needing depends on how your diabetes affects you, but the care team may include:
Dietitian: Diabetes is all about blood sugar management, so your diet plays a big role in how successfully you manage the condition. A dietitian can help you understand how many carbohydrates your body needs and how many are too many. They can help you craft meal plans that keep you within those limits.
Cardiologist: A person with diabetes is twice as likely to have heart disease or a stroke as someone who is non-diabetic. There are also several cardiovascular risk factors¹ associated with diabetes. Cardiologists specialize in the cardiovascular system, which includes the heart and circulatory system. Should these complications arise, or should your care team think you are at increased risk of them, you may be referred to a cardiologist.
Dentist: Diabetes also significantly increases your risk of developing gum disease. The American Dental Association recommends that patients with diabetes have regular checkups with a dentist. It also notes that treating gum disease can help improve blood sugar control.
Gastroenterologist: Similar to heart-related complications, diabetes carries an increased risk of gastrointestinal problems. The gastrointestinal tract includes the stomach and intestines. It's estimated that as many as 75%² of diabetic patients develop gastrointestinal symptoms such as nausea, bloating, abdominal pain, diarrhea, and constipation. Agastroenterologist can help with these symptoms should they develop.
Nephrologist: Diabetes is a leading cause of kidney disease. Diabetic kidney disease tends to develop slowly over a period of years, caused by the damage of excess blood sugar in the blood vessels of the kidneys. Nephrologists are doctors who specialize in the kidney. They can help you manage your condition if diabetes damages your kidneys.
Ophthalmologist: Among adults aged 20–74, diabetes is the leading cause of new cases of blindness. The American Academy of Ophthalmology suggests that diabetics have yearly checkups with an ophthalmologist to monitor the effects diabetes is having on their eyes. With early detection, 90% of vision loss from diabetes can be prevented.
Because diabetes is primarily about your body's reaction to the hormone insulin, a doctor specializing in hormones is well equipped to help you manage your diabetes. In addition to the aid of an endocrinologist, other specialties may be brought in to help you plan for the lifestyle changes needed to keep your condition under control or help you manage complications of diabetes should they arise.
When to see an endocrinologist for diabetes | Verywell Health
What is endocrinology? | Society of Endocrinology
Insulin| U.S Food and Drug Administration
Better blood glucose meters and more. | American Diabetes Association
About diabetes | Diabetes Caucus
Diabetes and your smile | Mouth Healthy
Nephrology | American Collage of Physicians