When should you see an Endocrinologist?

Cherokeemaiden
By Cherokeemaiden Latest Reply 2015-02-11 14:03:41 -0600
Started 2015-02-01 08:38:29 -0600

I have been having trouble trying to post discussions on here, so hope this goes through.

I have seen many people on here mention going to an Endo doctor. I was diagnosed 4 years ago as a type 2 and have never been advised by my primary care doctors (have had 3 different ones) that I should see one. I'm not even sure what an Endo doctor is. Should I be seeing one? Thanks for your help.


51 replies

RebDee
RebDee 2015-02-11 13:48:03 -0600 Report

I see my Endocrinologist every four months. I take a number of lab tests one week before seeing her. I bring my meter with me for off-loading. That way she has all the info and can make an intelligent calculated reason for me staying the same or changing something.

GeekonBoard
GeekonBoard 2015-02-09 19:31:45 -0600 Report

I was referred to an endocrinologist back in 2009. I wasn't a diagnosed diabetic at the time but my lab numbers were all over the map & I was having several female problems so I was actually referred to a reproductive endocrinologist. After going there several times - it seemed like compared with my PCP & their labs — this endo broke my labs down to a point I didn't know it could be taken to. I wasn't as educated on hormones as I am now — and I'm no where near as educated on hormones as I hope to be. Turns out that I have a malfunctioning pituitary gland & was in the process of being treated for that when I was laid off by the USPS & lost my insurance. My health has been neglected & hanging by a very unhealthy thread because I couldn't get health insurance thanks to pre-existing conditions. Last year I was finally able to obtain health insurance again & have been getting back on track. Of course, I was then hit by being diagnosed a T2, but I'm so grateful for health insurance & being able to get back on medicines that I wasn't able to afford w/o health insurance. So, after all that rambling - I'm scheduled to have my first appointment with my new endocrinologist later this month. I'm waiting on my records to be sent to me from the other endo. I have done my research on this endo & am very hopeful. I was relieved to find out that my insurance didn't require a referral, but my PCP gave me one anyway. I hope you find the answers about endocrinologist that are needed to help you with your journey with diabetes. Thank you all for sharing!

luiesp
luiesp 2015-02-04 23:26:00 -0600 Report

Your best bet is get your primary to give you a referral, then have your Endo monitor your a1c every 3 months

valentine lady
valentine lady 2015-02-04 10:46:32 -0600 Report

Hi Cherokeemaiden
Just wanted to add. I only see my endo every 6 months now. He helped me get off all medication for diabetes when the time
was right. My endo was a life saver for me when I saw no tests from my PCP. Now my PCP pretty much monitors me. If you don't get results from your PCP your seeking then get a an endo.

Sopies Grandma
Sopies Grandma 2015-02-03 17:50:43 -0600 Report

Hello, An Endo is a doctor who's field is nothing but diabetes. I have one and she is just wonderful. I also have a primary, she's pretty good to, and I only see her for other health issues, For diabetes I see the Endo. You should give it a try,
Im sure you will find that it will help a lot.

Cherokeemaiden
Cherokeemaiden 2015-02-03 18:06:05 -0600 Report

I will be seeing a new pcp the end of the month and will see what he has to say. Will ask him about an endo. I know they might be some help for me, but I live on a small SS check and would have to pay $25 each time I had to see an endo, so am hoping this new doctor is up to date on diabetes. Will have to wait & see what happens.

deni46
deni46 2015-02-03 12:10:27 -0600 Report

I have had over 20 operations concerning my lovely intestines. Needles to say I'm trying to keep what I have left. I do see a specialist for that nothing they can really do but keep an eye on if and when they get infected or scar tissue strangles them. But when I do get sick from the inflammation my sugars go sky high. After last surgery they didn't go down so insulin was called for. Now my bg if it spikes to 200 it's not there long.

lorider70
lorider70 2015-02-03 09:56:59 -0600 Report

I've been a type II since 1989. "symptoms" I exhibited at that time were already "complications" it seems. I have been on oral meds and diet ever since. Numbers always good; still the complications progressed…neuropathy, vision, etc. Never advised to see any other doctors either. Always just told that some things would abate; others would be permanent and progressive. Not much more I can say…

RebDee
RebDee 2015-02-11 14:03:41 -0600 Report

OMG, demand that you see an ophthalmologist for your eyes, and endocrinologist for your Diabetes. I see the endocrinologist either three or four times a year and because I am a Diabetic with eye problems I see the ophthalmologist or optometrist at least twice yearly. That is all in addition to labs every three months and seeing my PCP whenever I need it.

RebDee
RebDee 2015-02-11 14:02:42 -0600 Report

OMG, demand that you see an ophthalmologist for your eyes, and endocrinologist for your Diabetes. I see the endocrinologist either three or four times a year and because I am a Diabetic with eye problems I see the ophthalmologist or optometrist at least twice yearly. That is all in addition to labs every three months and seeing my PCP whenever I need it.

RebDee
RebDee 2015-02-11 14:02:30 -0600 Report

OMG, demand that you see an ophthalmologist for your eyes, and endocrinologist for your Diabetes. I see the endocrinologist either three or four times a year and because I am a Diabetic with eye problems I see the ophthalmologist or optometrist at least twice yearly. That is all in addition to labs every three months and seeing my PCP whenever I need it.

deni46
deni46 2015-02-03 00:00:13 -0600 Report

Ok when I was first diagnosed with type 2 they put me on metformin and within 6 months I was off it. Then several years later (the end of 2014 after a surgery) my numbers went sky high. Went to my doc and my a1c was 10.5. Before surgery my a1c was 7. Ok so my doc put me on metformin and lantus he has me taking 24 units in the morning and 45 units at night. I had a nurse tell me to go to someone else that I should be taking short acting with every meal. I trust my doc been through a lot and he wants me to regulate my diet so we can then start backing off the metformin first then adjust the lantus. I think that sounds like a good plan. Due to other medical problems it's very hard to keep a schedule. Does this sound crazy? Just want your opinions. I went from bg 500 to now I'm down to 90 -110 fasting and after meals 140-200 depending if my intestines flare up I spike. Ok gang give me your thoughts

Anonymous
Anonymous 2015-02-11 12:50:55 -0600 Report

deni, my PCP has readjusted my Metformin intake from 500, 750 to 1000 in one year! My fasting has avg'd 123 - 134 & under 160 2 hours aft meals (on 70 grams of Carbo a meal). Last visit because some doctors revamped the numbers to <140 2 hrs aft meals! My A1c was 6.2 and he wants them to be <6.0! I'm thinking about seeing another PCP and maybe a Endo as my friend who is T-1 does.

dwptingle
dwptingle 2015-02-07 14:36:55 -0600 Report

If I were in your situation I would find a good endocrinologist just to get a second opinion. I am like you in that I trust my family doc but diabetes isn't his specialty . It sounds like you are doing well, but the endocrinologist could give you more confidence and other tips to keep you healthy. Good luck.

jayabee52
jayabee52 2015-02-07 16:25:18 -0600 Report

Howdy DWP
WELCOME to DC!
As long as the endo specialized in diabetes care. I had an endo who specialized in the thyroid gland. I suppose she knew more about the pancreas than the average GP but her focus was on the Thyroid.

God's best to you
James

jayabee52
jayabee52 2015-02-03 00:35:16 -0600 Report

Howdy Deni
That 140 to 200 mg/dl has me a bit concerned. 140 mg/dl starts the range where one gets complications (if it stays above that range over 2 hrs). Of course I have heard that after a meal one can go up to 180 mg/dl for a brief period, as long as it comes down within about an hour or so.

You say your intestines "flare up". What is happening there? Do you have something going on with your GI tract?

The rest seems OK. As long as you trust your Dr, it is good. If you have good communication with Dr and can voice your concerns to Dr, I would say you shouldn't be looking for another.

God's best to you
James

Type1Lou
Type1Lou 2015-02-01 17:42:23 -0600 Report

I had been seeing an endocrinologist for my diabetes regularly until moving permanently to Florida in 2005 when I decided that my control was pretty consistent and that my PCP could handle it. Around 2010, I started seeing increased A1c's and, for the first time it got above 7.0. I was also having frequent low BG episodes requiring either a rush to the ER or glucagon injections (my husband learned to give me those). When my PCP kept increasing my dosage of Lantus while advising me to eliminate my fast-acting insulin, and, his advice landed me in the hospital overnight, I decided it was time for me to self-refer to an endocrinologist, a specialist in diabetes treatment. The endo actually reduced my Lantus dosage, re-educated me about carb to insulin ratios for my fast-acting insulin and eventually got me to try an insulin pump. If your diabetes control needs improvement and your PCP keeps giving you the same advice with no improved results, it might be time to seek out an expert.

RosalieM
RosalieM 2015-02-01 12:59:39 -0600 Report

The endocrine system is made of numerous glands that produce different
hormones. Diabetes is a problem of the pancreas which excretes the hormone
insulin. If you don't have issues with other glands in the endocrine system
than the doctor you have should do. Both your regular doctor and the Endo get their information and instructions from the American Diabetes and Association and the American heart Association. The American Diabetes Association's diet recommendations are incorrect as most on this board know. Their diet is way to
high in carbohydrates. The American Heart Association has the cholesterol
thing wrong. That is why diabetics get drugged so much. Drugs to lower glucose from the ADA and drugs to lower cholesterol from AHA. The right diet,
exercise and weight loss will take care of both the blood sugar and cholesterol. Most doctors know very little about diet and food for diabetics, so they rely on drugs. Drugs do not prevent complications. Diet and exercise can. You are in the right place right here.

Cherokeemaiden
Cherokeemaiden 2015-02-01 13:17:08 -0600 Report

Thanks, Rosalie, you have given me a wealth of information since I joined this site. The low carb eating is helping my numbers, but not my weight. Got weighed today, unfortunately it wasn't right after getting us, but I figured it'd give me a ball park figure of weight loss…still weighed the same as last week As you know my numbers ran anywhere from 135-174 fasting, and now they run between 125-136, so is an improvement that I'm happy with. But still anxious to get into the normal range. One day I did have a 98, but haven't since. The lowest I've been since then was 104, but most of the day it runs in 110's-120's, sometimes low 130's…but gone are the 170's! You have been a big help with all your suggestions and info. Thanks again.

RosalieM
RosalieM 2015-02-01 13:27:54 -0600 Report

Cherokeemaiden,
Thank you, That is great. If you get weighed at the doctors office, their scale run five pounds heavier than my bathroom scale and probably yours too. But that is ok as you can tell from your scale if your weight has gone down or not. If you don't start losing weight, you may need to cut back on the amount of food you eat as it may not match your activity level. Last year, I worked really hard physically every day. I lost weight and my diet is the same today. Now I am less active and I don't lose, but I don't gain either. If I start to gain I will cut back on the amount of food I eat.

sweetslover
sweetslover 2015-02-01 12:07:34 -0600 Report

I have not been to see an endocrinologist. My BG seems to be in control with what my primary has me doing, so I see no need in going to one. I am T2 on metformin. It might be a different matter if I was on insulin.

Pegsy
Pegsy 2015-02-06 16:57:54 -0600 Report

Same here. Although I would like to see my A1c lower than what my PC is satisfied with. I don't know if an Endo would have goals more in line with mine or not. In addition, I don't have a clue how to go about finding a good one without spending a lot of money on trial and error.

RosalieM
RosalieM 2015-02-01 13:37:16 -0600 Report

Sweetslover
It is not wise to be dependent on metformin but to work with your diet to get off it. Keeping your blood sugar down with a drug does not protect you from complications. Many of my customers (diabetics) take metformin and their blood sugar is lower than mine, but their feet are numb and kidneys and heart are showing signs of problems. My customers think they can have the carbs they want because their blood sugar is low. Those carbs go into the cells where the metformin cannot reach (even though their blood sugar is low) and causes nerve damage.
It is a shame the doctors don't understand this. The research is out there,
I saw it many times.

Pegsy
Pegsy 2015-02-06 17:02:57 -0600 Report

"Keeping your blood sugar down with a drug does not protect you from complications." What is your source on this statement? If this is true then I may as well stop taking the Metformin and allow my glucose to be high until I get it under control by diet alone. Why waste the money on prescriptions that don't really protect? I would love to view any studies that document your statement.

RosalieM
RosalieM 2015-02-08 07:38:06 -0600 Report

Pegsy,
Google Thiamine and diabetes and you will get all kinds of information. I don't know how to do links.
Look for the new discussion I started "Thiamine (B1) deficiency in diabetes and complications. I need more room to write.

sweetslover
sweetslover 2015-02-01 21:51:02 -0600 Report

I never said I was depending on my metformin to control my BG. I have been on it for 4 months. My primary has already made the comment that he wants me to be able to go off of it. I watch my diet very carefully and exercise a minimum of 5 times a week with this in mind. Yes, my feet are numb, but I was diagnosed with neuropathy by my neurologist before I was diagnosed with diabetes. My doctor fully understands the problem with eating too many carbs and has been sure that I have been educated in this area. Please do not assume that I am being irresponsible with my diet just because I am on metformin.

Cherokeemaiden
Cherokeemaiden 2015-02-01 15:54:56 -0600 Report

I'm hoping that in a few months I'll be able to get off Metformin. I have heard some bad things about taking Metformin…especially if you take it for a very long time. My goal is no meds whatsoever !
I've only been on low carbs for 3 or so weeks and already I can see my numbers coming down, so I'm encouraged.

RosalieM
RosalieM 2015-02-02 07:12:29 -0600 Report

Greatcherokee,
Metformin prevents the absorption of vitamin B12. It takes a long time to lower vitamin B12, but most are not told about it when they are given that drug. The result is dementia. If they were told, they could take some B12. with the metformin.

Cherokeemaiden
Cherokeemaiden 2015-02-02 10:14:59 -0600 Report

I remember you mentioning B12, so I just bought some and will start taking it right away. I hadn't previously known that about Metformin…just another reason to try & get off it. Thanks again for your wealth of information.

RosalieM
RosalieM 2015-02-02 11:31:10 -0600 Report

Cherokee,
That is good. As we age we have more difficulty absorbing B12 as the acid in our stomach is not as strong. The acid is needed to take the B12 out of meat.
When your are older as I am and you take metformin you get a double whammy. That is why I don't take metformin and I do take B12.

Cherokeemaiden
Cherokeemaiden 2015-02-02 13:22:41 -0600 Report

I'm 70 and I've started taking B12. My goal is to get off Metformin entirely, but it looks like that is a ways down the road. But hopefully one day it will be a reality.

RosalieM
RosalieM 2015-02-02 13:43:49 -0600 Report

I don't think it is that far down the road.
Just hang in there and keep working on the diet. Your seventy. Because of your age, you may not make enough insulin any more. The pancreas doesn't always work at full tilt when you get over 70. That is my problem. Metformin didn't help me and it seems as though it is not helping you either. I would find out if that is the case for you before taking more metformin and another diabetes drug.
I take a small amount of long acting insulin once a day and with it my blood sugar is fine. If you don't make enough insulin, a drug is probable not going to replace it and lower your blood sugar. Insulin probable will. If you can, get tested for it. Then you will know where you are.

Cherokeemaiden
Cherokeemaiden 2015-02-02 17:00:33 -0600 Report

I am going to check with my new doctor to see if I might try the long acting insulin. I'm not afraid of giving myself shots as I had to do it for two years for allergies. I'm sure it will have to do with how my blood tests come out…who knows, maybe I'll be able to do it with just diet. That would be fantastic. I don't see him for over 3 weeks, so still have time to work on the low carb eating to get my numbers in check. My ultimate goal tho is to get off any form of meds. Time will tell.

RosalieM
RosalieM 2015-02-02 17:50:49 -0600 Report

Hi Cherokee
Don't see long acting insulin as a drug but as a replacement hormone that your body makes. you may very well be able to just use the insulin and diet and no drugs.

Cherokeemaiden
Cherokeemaiden 2015-02-07 20:37:27 -0600 Report

I have been in contact with my insurance agent and she Lantus long acting in the pen form is a tier 3, which means I'd probably have to pay for most if not all of it, and that it's very expensive. Can you tell me what you use and how? I want to get all the info I can before I see my new PCP on the 27th. Thanks again for your help.

RebDee
RebDee 2015-02-01 10:50:54 -0600 Report

I belong to Kaiser-Permanente, so it may work a little differently than other insurances. I see my endocrinologist 4 times a year. In between, whenever I have to go to KP for something, such as a different physician's appointment, I bring in my BS meter and it is off-loaded at the Endocrinology Clinic and a report generated which is seen by the Endocrinologist who then tells me if there is anything wrong (if it is ok, I don't hear from her). This works especially well for me. I do lab work especially A1c one week before my appointment with her so she is aware of all my tests.

jayabee52
jayabee52 2015-02-01 17:00:49 -0600 Report

Dee, when I lived in the SF Bay area with my late wife "Jem" she had been a member of KP for about 20 yrs, and she got me in also. I found the level of care exceptionally good. If I could have stayed when Jem passed I would have loved to continue with KP.
The closest KP facility to where I live now is in Victorville CA. That is a bit far to go for a Dr appt.

RebDee
RebDee 2015-02-01 20:04:01 -0600 Report

I just found out that KP is in many other states (I originally thought that it was only in CA) but I don't know which ones. If anyone has a chance to join KP, I recommend it highly.

jayabee52
jayabee52 2015-02-05 02:38:41 -0600 Report

Dee, From the time I was on it I remember it being in Ohio, in the cleveland area. They were connected to the cleveland clinic there. There may be other KP outposts elsewhere since then.

Jibber Jabber
Jibber Jabber 2015-02-01 09:27:17 -0600 Report

I went to see my Endo because my PCP had about the same knowledge of diabetes as I have of WW2 fighter engines.

Cherokeemaiden
Cherokeemaiden 2015-02-01 10:08:24 -0600 Report

What exactly is an Endo doctor? Do they specialize in diabetes? Do I have to be referred to one and are they considered a specialist? I have to pay to see a specialist on my insurance plan.

Gabby
GabbyPA 2015-02-02 08:33:00 -0600 Report

Endocrinology is a broad specialization. You do want to find one that has chosen diabetes as their main focus. That way you are really getting what you need. They do not all focus on diabetes and if you get one who doesn't, you might be getting the same kind of info from your primary care. So choose wisely and ask a lot of questions.

Cherokeemaiden
Cherokeemaiden 2015-02-02 10:28:36 -0600 Report

Thanks for the advice. I will be seeing a new doctor in a few weeks, and will be able to tell more then as to his outlook on diabetes, but hopefully with this low carb eating I won't have to see an Endo ever ! Numbers are coming down so I'm encouraged.

RebDee
RebDee 2015-02-01 20:05:28 -0600 Report

Endocrinologists do specialize in diabetes and other systemic diseases. Yes, I had to be referred to one by my primary care physician.

Jibber Jabber
Jibber Jabber 2015-02-01 12:20:44 -0600 Report

As I said..I went to my Endo..and for all practical purposes changed doctors completely and started going to the diabetes clinic because I was not comfortable with the level of care I was getting from my PCP..my numbers are great..and when I told him what they were..he suggested adding a medication…ummm..not cool…If you are comfortable with the care your PCP is giving you and think he is providing you will the level of care needed..I wouldn't go see an endo…It raises all kinds of issues with our insurance…larger co-pays for seeing a specialist..some insurance companies may limit specialty care..If you are not happy with the care you are getting..if your doctor is NOT addressing your health issues to your satisfaction..first off look into changing doctors..but in the mean time you can ask your doctor for a referral to an Endo..or even see if your town/city has something like where I go..a full service diabetes clinic…that your insurance will cover…it is always better when your doctor has more experience with your particular condition..

misslulu
misslulu 2015-02-01 08:55:21 -0600 Report

It came through…I guess I thought you wouldn't need to see one unless you were having issues with your feet,pain and the needle thing…but I don't know either..I hope someone sheds some light on the subject..have a good day!

Next Discussion: Me Day »