- 5 Reasons to See an Endocrinologist If You Have Diabetes
- The Benefits of Seeing an Endocrinologist for Diabetes
- 12 Things Your Diabetes Doctor Wants You to Know
- …And That’s Why I Chose Endocrinology
- Endocrinologist: Your Diabetes, Thyroid & Hormone Specialist
- Who should see an endocrinologist?
- When should you see an endocrinologist?
- What does an endocrinologist treat?
- What does an endocrinologist test?
- What procedures and treatments does an endocrinologist do?
- How do I choose an excellent endocrinologist?
- Diabetes Doctors: What Does a Diabetologist Do?
- Get on top of your general health
- Meet your healthcare team
- Getting a second opinion or making a complaint
- Out-of-hours or emergency support
5 Reasons to See an Endocrinologist If You Have Diabetes
Last fall I didn’t want to go to my endocrinologist because I was worried about the possible results of my latest A1C test. Seemingly 5 pounds heavier than my last visit, I had no interest in being weighed. Although I fully know how important it is to take your blood sugar regularly when you have diabetes, I hadn’t been doing so, and when I did test it, I didn’t like what I saw. There were mornings when I woke to a spike in my glucose or late afternoons when, after skipping lunch, it dropped too low.
If only I had exercised more. Or eaten fewer carbs. Or not stressed out about every little thing. I was ashamed that I hadn’t worked harder. How had I fallen so off track? What would my doctor think of me?
The Benefits of Seeing an Endocrinologist for Diabetes
Of course, endocrinologists who specialize in diabetes care aren’t there to judge patients. Their job is to go over your blood tests, particularly your hemoglobin A1C readings, which tell you the two- to three-month average of your blood sugar level. They’re there to check your feet, to make sure your circulation is healthy; to take your blood pressure; to respond to any problems you may have encountered since the last visit; and to fine-tune your diabetes care.
Despite this knowledge, when it comes to my hesitation to visit my doctor, I have a feeling I’m not alone. But no matter about these worries, Eileen Sturner, manager of diabetes and outpatient nutrition at Abington Jefferson Health in Pennsylvania, has one message for her diabetes patients: Keep the appointment.
“Whether it’s the dietitian, the primary-care physician, or the endocrinologist, we’re all here to help patients achieve good care,” Sturner says. “So even if from the patient’s perspective they are not achieving what they want to achieve, going to appointments are an opportunity to brainstorm with the practitioner on how to tweak their plan so they feel better each day.”
There are other good reasons to keep that appointment as well:
A1C doesn’t measure how good or bad you are. “Your A1C is a three-month average of your blood sugar that is used by your physician to guide your treatment plan,” says Sturner, adding that it’s just another tool that offers insight into your level of control. When testing your blood glucose day to day, it’s sometimes hard to get an overview. Having my doctor discuss the results with me, whether they’re good or bad, helps me get a better perspective on how well I’m doing.
You may need to change your diet. A visit to your endocrinologist may pave the way for an appointment with your dietitian — or if you don’t already have one, it may motivate you to find one. Because there’s no one-size-fits-all diet plan for people with type 2 diabetes, you may see a benefit in tinkering with your own meal plan. Over the years I’ve experimented with reducing carbs and fats, and talking to my endocrinologist has helped me understand why these moves might improve my blood glucose. “There’s lots of ways to manage nutrition that can make a big difference in diabetes management,” Sturner explains.
It will give you a deadline. If you’ve been cheating here and there on your diet or taking your blood glucose, visiting your doctor might grant a do over. After I leave my doctor’s office, I feel like I’ve turned the page and can start fresh on my exercise and diet plans.
Hiding never solves anything. Few people would skip a dental appointment because they missed brushing their teeth a few times or forgo an allergy shot if they’d been sneezing. So why let diabetes take up more emotional weight than any other medical condition? Despite my initial discomfort, I have to admit that I always learn something new from my endo visits. During my last appointment, for example, we talked about my exercise program and how I might tweak it to add another day of weight lifting.
It will make you feel in charge. “Diabetes is significantly patient managed, and working with an endocrinologist can help patients interpret how well they’re managing,” says Sturner. “Going to the doctor on time can help you continue that sense of self-efficacy.” When the doctor reassures me I am doing fine and that everyone has occasional bad days, I feel more confident about my ability to handle the chronic disease. And if my numbers are off, he gives me tips on how to better manage them, which leaves me better prepared for the future.
So in the end, I did go to my endocrinologist. And here was the kicker: I had a perfectly good A1C. I had gained only 3 pounds, and my doctor was pleased. I left the office feeling healthy and relieved.
But there was more. By facing the doctor on the correct schedule, it showed that I own this disease and that — despite my worries — it didn’t own me.
12 Things Your Diabetes Doctor Wants You to Know
10. “Not everyone needs to see an endocrinologist.” https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/1494×999%2B5%2B0/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F8c%2F95%2Faa3df1a0499bb3b5ae7414302d1e%2Fresizes%2F1500%2Fimage-gettyimages-761609801.jpg
There’s no cure for diabetes, and avoiding its long-term health risks takes consistent effort. “Diabetes is unique in that self-management is such an important part of the treatment,” Dr. O’Shaughnessy says. Your doctor can act as a coach, motivator or resource, but the daily task of diabetes management is in your hands.
11. “Diabetes is a lifelong challenge …” https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/5616×3757%2B0%2B0/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F06%2F95%2F622a20cf40749b5aef034c0534de%2Fimage-middle-age-male-in-gym.jpg
With proper management—including blood glucose monitoring, a proper diabetes diet, and regular visits to your diabetes doctor—people with the condition can live full, healthy lives. And don’t fret if you take a wrong turn or two along the way. “It’s not the end of the world. This is a slowly progressive disease, and you can turn things around and get back on the right path,” Dr. Hamdy says.
12. “ … but if you control diabetes, it won’t control you.” https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/1496×1001%2B0%2B0/resize/580×388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F11%2Fbf%2F7cd576bd436a932a9402edd533f9%2Fresizes%2F1500%2Fgettyimages-464727639.jpg
Healthgrades would like to thank the following physicians for their contributions to this content:
- Osama Hamdy, MD, PhD, is medical director of Joslin Diabetes Center’s Obesity Clinical Program, an instructor at Harvard Medical School, and the author of The Diabetes Breakthrough.
- Scott Isaacs, MD, is medical director of Atlanta Endocrine Associates and the author of Hormonal Balance.
- Irene O’Shaughnessy, MD, is medical director at Froedtert & the Medical College of Wisconsin Endocrinology Clinic and co-medical director of the Diabetes Care Center.
- Richard Shewbridge, MD, practices endocrinology at Cleveland Clinic’s Medina Hospital.
An endocrinologist diagnoses and treats hormone-related disorders such as diabetes and thyroid disease. Endocrine glands include the thyroid, parathyroid, pancreas, ovaries/testicles, hypothalamus, pituitary glands and adrenal glands. Patients are often referred to endocrinologists because endocrine disorders are complicated. Endocrine disorders often affect different parts of the body and require a comprehensive understanding of how the hormone glands work.
Here are six reasons why you should see an endocrinologist rather than a primary care doctor.
Diabetes is the most common endocrine disorder in the U.S. It includes type 1 diabetes, type 2 diabetes and gestational diabetes. People with diabetes must manage their blood sugar levels to control symptoms, which include thirst, fatigue and blurry vision.
2. Thyroid Disorder
The second most common endocrine disorder in the U.S. is thyroid disorders. The thyroid regulates your metabolism. It’s possible to have too much or too little of the thyroid hormone, leading to a wide range of symptoms like weight gain/loss, hair loss, anxiety, etc. Medications are typically used to balance out the thyroid hormones and relieve symptoms.
Osteoporosis refers to the thinning of the bones. As sex hormones decrease with age, it raises the risk for some people to develop osteoporosis. Genetics and medications also play a role in the development of osteoporosis. The main treatment is to strengthen the bones and decrease bone loss, which can be achieved with strength-building exercises and medication.
4. Low Testosterone
Low testosterone affects millions of American men. Though many people assume that low T is just troublesome in the younger years, it can also have negative effects for older adults. Low testosterone levels can cause symptoms like fatigue, depression, muscle weakness and hair loss. Hormone replacement therapy may be used to restore T levels.
5. Endocrine Gland Cancer
Endocrine gland cancers include thyroid cancer, parathyroid cancer, adrenal cancer and pituitary cancer. These cancers can affect hormone levels. Usually, people with these types of cancers will work with both an endocrinologist and an oncologist. The oncologist deals with the cancer treatment while the endocrinologist help balance hormone levels.
6. Polycystic Ovary Syndrome (PCOS)
Women with PCOS have higher levels of androgens (male hormones) and insulin, which can lead to larger ovaries, irregular periods, metabolic problems and cysts. In the younger years, PCOS can make it difficult to get pregnant. As people get older, they may suffer more from the metabolic side effects, including weight gain and excessive hair growth.
If you have an endocrine disorder, it’s a good idea to add an endocrinologist to your healthcare team. This way, you can receive an accurate diagnosis and appropriate treatment plan.
…And That’s Why I Chose Endocrinology
Matfin, a consulting physician with the UK’s National Health Service, says that he has never been disappointed with his career choice of endocrinology and diabetes. “The intellectual process of combining focused history, targeted physical exam, and diverse investigations culminating in correct diagnosis and appropriate treatment and monitoring is very satisfying and a great benefit for the patient whose condition has often not been diagnosed or managed optimally,” he says. “A career in endocrinology and diabetes has also personally benefitted me in many ways including allowing me to travel and work internationally; meet and interact with basic and clinical thought-leaders; be engaged in experimental and translational research leading to novel diagnostic tools and therapies; and attempt to demystify and share endocrine and metabolic knowledge with undergraduates and clinicians alike. Last but not least, it is always a pleasure and privilege (no matter how fed-up we are feeling!) to care for persons (and families) with endocrine disorders. Endocrinology is an evolving and fast-moving field, and it never ceases to stimulate or surprise.”
“With hindsight, endocrinology has always struck me as the queen of the cognitive specialties: a discipline that provides continuing intellectual stimulation, pragmatic satisfaction, and great promise of discovery,” Dagogo-Jack explains. “The allure of endocrinology is the mastery of a much broader range of organs, glandular systems, and signaling pathways than is typical for the other subspecialties.”
“It is always a pleasure and privilege to care for persons with endocrine disorders. Endocrinology is an evolving and fast-moving field and it never ceases to stimulate or surprise.” — Glenn Matfin, MD, consulting physician, National Health Service, UK; editor, Endocrine and Metabolic Medical Emergencies
According to Hussain, endocrine disorders bring in a range of other issues including public health, preventative medicine, policy, health economics, healthcare systems, medical informatics, cultural issues, clinical leadership, patient self-management, and engagement. “To sum it all up, endocrinology is a fascinating and challenging multi-dimensional specialty that opens the doors to an array of stimulating opportunities packaged into a family-friendly environment. So why would I choose anything else?”
— Newman is the editor of Endocrine News. He wrote about online communities for young adults with endocrine disorders in the November issue.
An Endocrinologist Helps Non-Traditional Patients
Some patients have diseases that progress as the textbooks say they should. The standard treatments work and they are able to manage their conditions with oral or injected medication with minimal disruption to their day-to-day living.
Other patients find that conventional treatment does not work. They stick with the treatments religiously, but they achieve no results. In these cases, an endocrinologist is necessary to ensure all possible treatment avenues are pursued.
Some patients need unique care due to other health conditions that affect their hormonal conditions. They may have a genetic condition, like cystic fibrosis, that affects the way their bodies react to treatments.
The traditional-path patients may not see the value of an endocrinologist. Those who are in one of the latter categories, however, do. It’s these non–traditional patients that absolutely need the help of an endocrinologist to treat their hormonal conditions.
An Endocrinologist Knows the Latest Treatments
Our knowledge and understanding of hormonal diseases is constantly changing. An endocrinologist’s job is to know these changes and understand the newest treatments that are available to today’s patients. Patients who choose an endocrinologist will have access to the latest, most innovative treatments for their conditions.
An Endocrinologist Works with Your Primary Care Doctor
Visiting an endocrinologist does not mean you will never see your primary care doctor again. Going to an endocrinologist when struggling with a hormonal condition gives you another set of eyes to ensure your health is as good as it can be.
Remember, your goal when facing a hormonal disease diagnosis should be to take care of your condition as best as possible. This is often done with the support of an endocrinologist.
Endocrinologist: Your Diabetes, Thyroid & Hormone Specialist
Who should see an endocrinologist?
In most cases, people visit an endocrinologist when their primary care doctor refers them to one. The purpose of the referral is for an expert diagnosis or treatment of an endocrine problem. However, an endocrinologist is not a surgeon. If you need surgery, your endocrinologist will refer you to a surgeon.
If you require continuing care for an endocrine condition, your endocrinologist will let you know if you should continue to see him or her or return to your primary care doctor. In general, your primary care doctor can treat and manage uncomplicated hormonal disorders. For more complex hormonal conditions, your endocrinologist will most likely remain involved in your treatment.
When should you see an endocrinologist?
Consider seeking care from an endocrinologist under the following situations:
You are diagnosed with more than one endocrine problem or a complicated endocrine disorder.
You are looking for a second opinion about an endocrine diagnosis or treatment strategy.
You are newly diagnosed with an endocrine disease and require expert treatment recommendations.
You have an endocrine disorder that has been stable, but you are now having problems managing it.
You require an expert diagnosis for new symptoms of an endocrine disorder.
What does an endocrinologist treat?
An endocrinologist treats conditions and diseases that involve hormonal imbalances or other problems with your body’s endocrine glands. Hormones act as chemical messengers in your body. Because of this, hormone or gland problems affect many of your body’s systems and are often connected. These conditions include:
Bone disorders including osteoporosis, osteomalacia (rickets), hyperparathyroidism (overactive parathyroid), Paget’s disease, and bone problems from long-term corticosteroid use
Cardiovascular endocrine problems including endocrine-related high blood pressure, high cholesterol or cholesterol problems, primary aldosteronism, and pheochromocytoma (a rare adrenal gland tumor)
Diabetes including type 1 diabetes, type 2 diabetes, gestational diabetes, diabetic neuropathy, and prediabetes
Endocrine gland cancers including thyroid cancer, pancreatic cancer, breast cancer, ovarian cancer, testicular cancer, adrenal cancer, and pituitary cancer
Growth disorders including acromegaly, gigantism, growth hormone deficiency, short stature, early puberty, delayed puberty, and Turner’s syndrome
Hormone abuse including abuse of anabolic steroids, steroid precursors, supplements, and endocrine disruptors, such as estrogen blockers
Obesity and overweight including metabolic syndrome and weight problems related to thyroid, adrenal, ovarian, pituitary and insulin disorders
Pituitary disorders including benign tumors, growth problems, hypopituitarism (underactive pituitary), hyperprolactinemia (too much prolactin), and Cushing’s syndrome
Reproductive conditions including infertility, polycystic ovary syndrome, endometriosis, erectile dysfunction, decreased sex drive, low testosterone, premature ovarian failure, menopause, and Klinefelter’s syndrome
Thyroid disorders including hyperthyroidism (overactive thyroid), hypothyroidism (underactive thyroid), Grave’s disease, Hashimoto’s disease, thyroid nodules, postpartum thyroiditis, and goiter
What does an endocrinologist test?
An endocrinologist can order or perform a wide variety of diagnostic and screening tests for endocrine or hormonal health problems. These tests include:
Biopsies including fine-needle aspirations
Blood tests including hormone blood levels, blood chemistries, and blood glucose tests
Hormone tests including dexamethasone suppression tests, adrenocorticotropic hormone (ACTH) stimulation tests, corticotropin-releasing hormone (CRH) stimulation tests, and oral glucose tolerance tests (OGTT)
Imaging exams including radioisotope scans, bone density tests, ultrasounds, CT (computed tomography) scan, MRI (magnetic resonance imaging), and EKGs (electrocardiograms)
Urine tests including urinalysis and 24-hour urine collections
What procedures and treatments does an endocrinologist do?
Endocrinologists order or perform various procedures and treatments to manage hormonal conditions. If you need surgery, your endocrinologist will refer you to either a general surgeon or a specialized surgeon depending on your condition. Common endocrinology procedures and treatments include:
Counseling including behavior modification for obese and overweight patients
Diet including medical weight loss treatments and nutrition education
Exercise and fitness counseling including weight-bearing exercises and cardiovascular conditioning
Medications including hormonal therapy, hormone replacement, hormone blockers, vitamins, diabetes medications, insulin, targeted biologic therapies and cancer chemotherapies
Radiation including radioactive isotopes for hyperthyroidism, radiation therapy, and other applications
Recommendations and referrals for surgery including partial or full removal of an endocrine gland, weight loss surgery, and surgery to remove cancerous and noncancerous tumors
How do I choose an excellent endocrinologist?
To find a doctor with the right qualifications, look for an endocrinologist who is board certified in endocrinology. Board certification verifies that a doctor has completed an endocrinology residency and passed an exam verifying her expertise. A board-certified endocrinologist is an MD or DO who has completed subspecialty fellowship training and has earned certification in endocrinology, diabetes and metabolism by the American Board of Internal Medicine or in endocrinology by the American Osteopathic Board of Internal Medicine. Both Boards require prior residency training and certification in internal medicine. To maintain board certification, an endocrinologist must participate in an ongoing certification program.
To set up an appointment with an experienced endocrinologist today, discover board-certified endocrinologists near you.
When you call a doctor’s office for information, ask about his expertise and success treating your particular condition. Some endocrinologists focus their practice on one or two endocrine system diseases and are highly skilled at treating them, such as:
High blood pressure
Lipid and cholesterol disorders
Obesity and overweight
Pituitary gland disorders
If your child needs to see an endocrinologist, look for a board-certified pediatric endocrinologist. Pediatric endocrinology is a subspecialty of pediatrics.
Diabetes Doctors: What Does a Diabetologist Do?
What’s the difference between a diabetologist and endochronoligist?
Diabetologists are generally endocrinologists with a special interest in diabetes.
What medical conditions do diabetologists treat?
- Diabetes Type I
- Diabetes Type II
- Complications of diabetes
Treatment for diabetes
Treatment of diabetes usually involves a multidisciplinary team.
The diabetologist coordinates diabetic educators, nurses, podiatrists, ophthalmologists and renal physicians to educate, treat and monitor a patient.
Treatment usually involves medications either orally or insulin injections.
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What to expect at your first visit with a diabetologist
Your diabetologist will ask about your diabetes in detail. They will ask about:
- Current symptoms
- Duration of illness
- Complications of diabetes
- Level of control you have had
- Other illnesses
- Social history
Your diabetologist will perform a general examination but will particularly focus on searching for complications related to your diabetes.
These generally involve the cardiovascular system (heart and blood vessels), the eyes (retinal vessels), kidneys and nerves.
Specialty areas of interest
- Paediatric diabetes
- Blood tests
- Blood glucose measurement
- Glycated haemoglobin (HbA1C)
- Urine protein collection
- Fluorescein retinal angiography
Training and qualifications
- Basic medical training
- Specialty Training
- Find a Diabetologist
- Diabetes Australia
- Baker Heart and Diabetes Institute
- Wikipedia – Diabetology
Q: Where can I find GP clinics?
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This article is for informational purposes only and should not be taken as medical advice. If in doubt, HealthEngine recommends consulting with a registered health practitioner.
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Getting a second opinion or making a complaint
If you want a second opinion on the treatment you’re getting, your healthcare team will be more than happy to ask their colleagues to see you. Or you can ask your GP for a new referral to a new team.
If you’re not happy with the care or advice you’re getting from a member of your healthcare team, ask the GP practice, hospital or clinic for a copy of their complaints procedure. It’ll tell you who to complain to and if there’s any kind of time limit.
Put your complaint in writing and keep a copy. Be clear about what’s wrong and what you want to happen. Keep a copy of their reply and if it’s by phone, ask them to put it in writing.
If you’re still not happy, you can complain to the Ombudsman. There’s more information about this at Citizens Advice.
Out-of-hours or emergency support
Most GP surgeries and diabetes clinics will have an out-of-hours service. Make sure you know what the numbers are so you can call if you need to.
If there isn’t an out-of-hours service and you live in England, Scotland or Wales, call 111. It’s a free NHS helpline for urgent medical help.
If you’re very ill, go to a hospital Accident and Emergency department immediately. Or call 999 for an ambulance.