Endocrinologist

FiveKids
By FiveKids Latest Reply 2014-08-28 11:05:48 -0500
Started 2008-10-05 12:35:55 -0500

I was told by my family practioner, when I was diagnosed as type 1 this past June, that if everyone that has diabetes in our area wanted to see an endocrinologist they would not be able too. He was almost right, the earliest appointment I could see one is not until Oct 21. My regular doctor has me on the traditional pen bolus injections before each meal based on the amount of carbs I will be eating and the long lasting insulin injection once a day. I monitor my glucose levels 6 to 7 times a day and have had only two hypo readings. This has brought down my A1c level from 14.8% to 7.9%.

I would like to have advice on what I should ask the endocrinologist at this first visit.


17 replies

RebDee
RebDee 2014-08-28 10:56:19 -0500 Report

I have an appointment with my Endocrinologist every four months. In between, I bring in my meter and they take off the readings and if anything is wrong they contact me for an earlier appointment so that I don't have problems. I really like both my Endocrinologist and her Physicians Assistant who contacts me and checks me every two weeks by meter reading.

Bluebutterfly
Bluebutterfly 2008-10-15 21:00:48 -0500 Report

I just recently saw an Endo doctor. I don't know what they do that is any more than a PCP that is diabetic approved.My PCp has took care of me for years I mostly wanted the Endo for thyroid issues.

azmisty
azmisty 2008-10-23 07:58:40 -0500 Report

Well, I actually love my PCP and she is really awesome…but I felt that I needed a fresh approach…and it worked…the endo put me on Byetta and within just 2 days my numbers were so good that she took me off of my insulin. I was taking 100 u per nt…so this was a great change for me. And, I was lucky enough to lose 10 lbs in 1 week!

Misty

azmisty
azmisty 2008-10-08 16:54:09 -0500 Report

Well, I waited for almost 3 months to just be able to make the appt with the endocrinologist and then it took another month to get to see her. She does specialize in diabetes and I originally thought that the long wait was because she was listed as the top Doc in her field in Phoenix.

But the wait may have more to do with how thorough she is. My first appt was today and she spent 1 and 1/2 hours with me…and at 66 gave me a more thorough exam than any Dr ever has.

She also took one of the most exrensive medical histories and asked so many questions that I wasn't sure how pertinent some of the info was.

I am really impressed with this woman and happy that I found her. I will let you know how my treatment progresses.

Misty

kdroberts
kdroberts 2008-10-08 00:56:32 -0500 Report

Yes, it's true. Endocrinologists are one of the most oversubscribed specialties. I read some where that if everyone who had diabetes wanted to see one each endo would have a patient load of something like 15,000. It also said that less med students are specializing in endocrinology and of the current ones, a large proportion are getting up their in age and a lot will be retiring in the next 10 years.

As for questions. Take a list of whatever you want to know. Ask about blood tests (what you've had, what they mean and what you should have, eg blood glucose, a1c, c-peptide, insulin, antibodies, blood pressure, cholesterol, urine, etc), what are your goals going to be, how do you attain those goals, ask about supplements and herbs, ask about exercise and how to handle it, ask about wen and how often you should test, ask for prescriptions for 2 glucose meters of the same type and plenty of test strips to go with them, ask about when you should start to get concerned with your blood sugar and when you should call the doctor for advice, ask about the dawn phenomenon and the somogyi effect. Literally ask everything you can, make sure the doctor answers the questions in a way you understand them and don't go until you are satisfied. The more questions you ask, the more answers you will get and it will lead you to asking other things you may not have thought of. No question is dumb.

2008-10-08 01:58:12 -0500 Report

Hi kdroberts,
Could you explain what DAWN PHENOMEN and
SOMOGYD EFFECT is? I haven't these terms before. Thank You,
Nancy

kdroberts
kdroberts 2008-10-08 02:32:18 -0500 Report

This is from another thread I posted in so it might not all make sense, but it should have info about what the two are.

Dawn phenomenon (DP) is an interesting thing and not easy to figure out.

Firstly, everyone in the world has it, diabetic or not. It's your bodies
mechanism for waking up. Your body starts to release hormones that are supposed
to slowly increase your blood sugar and wake you up. In people without diabetes
this works fine. In diabetics too much glucose can be released or the mechanism
doesn't shut off. It also has a little to do with small amounts of glucose
being slowly released through the night to keep your vital organs supplied when
you're not eating. It does depend on your evening numbers too. If you are
higher than normal when you go to bed you will be higher than normal when you
wake up.

Now, the DP is very often crossed with something else. A lot of people say it's
a liver dump which it isn't. The other prime source of high morning numbers is
reactive hyperglycemia, or the Somogyi Effect. This happens when your blood
sugar dips too low and your liver over compensates by releasing glucose. Hence
the name liver dump. It can happen at any time but it's most common at night or
during periods of activity.

The last way you can have high numbers in the morning is if you take insulin and
your insulin is wearing off too soon.

It's hard to say what's happening without doing some not fun tests. You will
need to set your alarm for various times during the night to test and see. For
instance, if you test at about 3am and see you are at 50, then your high numbers
are likely because of the Somogyi Effect. If you test then and you're at 90
then chances are you have the DP, and if you take insulin you have that option
too.

Some things to do are test before bed, test at about 3am, test immediately when
you wake up and test when you eat breakfast, make sure it's at least 30 mins
after the waking test. If you are suffering from the DP then you will likely
see that the 3am test is lower than your bedtime but not really high, the waking
one will be higher and the before breakfast will be higher still. If you have
the Somogyi Effect then your 3am will be low or close to low, your waking will
be high and your before breakfast will be a little lower. If your insulin is
running out it will look similar to the DP but you may find that the 3am test is
a little lower but not low.

RebDee
RebDee 2014-08-28 11:05:48 -0500 Report

Thank you so much for your explanation. I will try to work in a 3am test as I seem to awake at that time for urinating anyway. Never was told to take blood sugar at that time of the night.

2008-10-24 10:57:47 -0500 Report

Great wording; easy to understand, and I learned a lot from that post. thanks

Starfire - 23364
Starfire - 23364 2008-10-08 02:25:01 -0500 Report

what is DAWNPHENOMENON AND SOMOGYI?????

Starfire - 23364
Starfire - 23364 2008-10-08 06:27:10 -0500 Report

THANKS AGAIN KD, YOUR A GREAT SORCE OF IMFOR. I HAVE ONE FOR YOU .I NEVER KNEW TO MUCH ABOUT NEUOPATHY I KNOW I HAVE IT IN MY LEFT LEG, BUT NOW I THINK I MIGHT BE GETTING IT IN MY RIGHT LEG, AND BOTH FEET ,PLUS MY ARMS LATLEY HAVE HAD A TINGLEING IN THEM DOES THAT SPEAD? IS THERE ANYWAY TO STOP IT, IT JUST STARTED IN MY ARMS OR DO YOU JUST LEARN TO LIVE WITH IT??

Starfire - 23364
Starfire - 23364 2008-10-07 23:42:51 -0500 Report

I myself could not be seen by an endocrinologist till Dec 15 its a long wait till then I really don't know what they do, could any-one tell me what they do?? They much be very important to have people waiting 2 months to see them.

kdroberts
kdroberts 2008-10-08 00:57:50 -0500 Report

Diabetes is considered an endocrine disorder and endocrinologists specialize in that. It doesn't mean they all specialize in diabetes though. If you are going to see one, make sure they sub-specialize in diabetes.