Help! Endocrinologist or Diabetes Educator

By PRP Latest Reply 2010-06-28 13:33:00 -0500
Started 2010-06-07 08:47:41 -0500

I need help in deciding whom to see ASAP to get better answers regarding my sugar levels. I was diagnosed Type 2 6 weeks back and have been tracking by blood sugar levels since then. I was prescribed glucophage but wanted to try diet and exercise so no medications yet. Now after looking at the trends I have lot of questions. I have heard that the Endocrinologist might be too busy to sit down and discuss a whole bunch of issues other than the clinical stuff and a diabetes educator might be better. But will a diabetes educator have enough knowledge about diabetes to suggest not only diet and exercise recommendations but also steer me in the direction of meds if they are necessary? Or should I just see both ? if so whom to see first ?


24 replies

PRP 2010-06-21 13:06:13 -0500 Report

After fighting with my doctor and Insurance, finally today, I got an OK to go meet a RN in the Diabetes Education center in the nearby hospital. I am supposed to be meeting with the Diabetes educator for a 1 - 2 hr session in two weeks and after that he will recommend whether I take an individual class or a group class. Once again thanks for everybody all the help and advice. I will update the discussion after i attend the class.


busboy1200 2010-06-18 20:49:01 -0500 Report

I suggest starting with a Diabetes Educator and go from there. Check out your local hospital and see if they have a Diabetes clinic. If they do most have a Nutritionist there so you get not only educated but you get nutritional and medical counseling. They may even offer a support group. I went to several doctors and finally found my local Diabetes clinic. I have to say they saved my life. I got all my questions answered, see a nutritionist, lost 30 lbs and my bg is now under control. I feel better than I have in several years. You can always see a doctor if you want to also.

Linda49 2010-06-16 06:49:04 -0500 Report

A doctor will definitely put you on meds. I have lowered my blood sugar with diet and vitamins. Did you know that Alpha Lipoic Acid is a natural blood sugar lowering vitamin, as is cinnamon. I take 100 mg twice a day.

PRP 2010-06-18 08:01:40 -0500 Report

Thanks for the tip. I have heard that cinnamon helps in lowering blood sugar. I did not know about the Alpha Lipoic Acid. I was trying to see how I can incorporate cinnamon. But if there is a vitamin that helps I dont mind trying that. I have a question regarding the side effects. I read that this reduces the blood pressure. What has your research revealed regarding this. I am a little bit concerned because my doc has put me on medication to lower my blood pressure.


PRP 2010-06-10 07:33:51 -0500 Report

Thanks everybody for all the helpful answers. This clearly show how invaluable this kind of community driven knowledge is in understanding and dealing with a complex issue like diabetes. After reading through all this and researching more I will enroll in a class.

I got a list of programs from website and I am in the process of enrolling into an "Individual Diabetes Management class" or a "Group class". I am planning to take this at Howard County General Hospital in Maryland. I found that this program is sponsored by Johns Hopkins University. I am waiting to hear from the hospital how much each costs and whether my insurance will cover that. Even if it does not I will pay from my pocket as long as it is reasonable.


ccritch 2010-06-09 15:53:33 -0500 Report


I saw an endocrinologist for 5 years and my sugars were out of whack I mean 300's to 400's, currently I am working with both my primary care doctor and diabetes educator and ever since I made that decision my sugars have not risen past 300 or 200, I have been in the 122 to 150 range it took a while and I feel so much better, I was getting very sick. Endocrins are great at what they do but they also have a lot on their plates and see a lot of different people for different illnesses not just diabetes. So you need to search and find which one is better for you. Have you tried going to Diabetes Education classes? They are helpful and will teach you alot and ease your mind. You can do it with exercise and right foods. But remember to check your BG's before and after your biggest meal to make sure what you are eating is not going to raise your sugars and/or not eat enough and have a low BG.

Take Care

davidvermont 2010-06-09 11:19:38 -0500 Report

When I was first diagnosed with T2, my primary Dr. told me I didn't need to see an endocrinologist. He also told me to go home and stop eating sugar. And he did NOT tell me (maybe didn't even know) that the endocrinology dept at the local Health Center had a diabetes clinic. It takes MORE than 3 months to get an appt with my endocrinologist who is excellent. But she has me see her every 6 months and in between see a nurse practitioner who is also a diabetes educator. Like Doctors, there are good educators and bad ones, but I do find that a good nurse practitioner is often more informed and attentive than many physicians. The clinic also has a dietician available and guest speakers a couple nights a month. Tonight I am going to hear a specialist speak on neuropathy. Vermont has new laws requiring insurance coverage of all diabetes needs and I am very fortunate to have excellent care. But I still find that much of the best information frequently comes from other diabetics and their real life experiences.

Lakeland 2010-06-08 21:55:07 -0500 Report

I did get in with a diabetes education class & mine was a registered nurse who teamed up with a dietition & ran a class to help new commers. It was so nice because we filled out what we ate and the numbers before & after we ate, so the next class she'd look at everything & give suggestions on where I might have went wrong. I also wrote down how much walking I did.

The class was to begin 3 weeks later, so she gave me an hour consult to get me started, plus she gave me her extention if I had questions about anything, food, my meter anything at all.

I'm glad I went, I learned alot.

ccritch 2010-06-09 16:01:43 -0500 Report

I am glad you went, it helps to know there are people who educate themselves to help us. I started my Education class today and I learned alot in 4 1/2 hours, not to mention the Pharmacist came up to speak with us about the types of medications and what they do and how they help and symptoms, reactions, and what is best and what you shouldn't take without discussing with your doctor first. She told us about the warning signs and FDA etc… It was great getting the knowledge and care from someone who took the time to educate themselves. You know it puts your mind at ease. Next week Class 2 will discuss Carb counting, calorie counting and Total fat and serving sizes. How to read food labels. That will be interesting.

Lakeland 2010-06-15 20:35:21 -0500 Report

You'll learn alot when you start watching carbs & reading labels. I had fun looking at cerials, believe it or not some of the childrens cerials have less carbs & higher fiber than so called healthy cerials. So I cook breakfast every day, I eat eggs & light sausage. one doctor suggested I cut back on the eggs because of cholesterol, but for me one thing at a time, I just want to get my sugars regulated & then I'll deal with the next issue.

Just remember, High fiber as a carb. the body has a hard time processing high fiber & that means it slowly turns the carb into glucose as compared to simple sugars & processed carbs.

I post this alot but it really helped me. They told me to pick the carb first. you'll learn that 15 grams of carbs is one carb serving & they'll tell you your allowed 3 carb servings per meal. I'm not that picky. but I do choose my carb, if I want bread than I don't eat a baked potato, or I'll skip dessert.

Tonight I made a bad choice but I knew I was doing it. my husband wanted pasta & we went to italian restaurant. I chose the spagetti & italian sausage, I new I was getting protien in the sausage but the, pasta, bread, salad dressing, sauce always has sugar in it. so there were alot of carbs & my sugar is high tonight, even after a walk I'm at 156. For me that's high, but I'll wait a couple more hours & retest & see if the medicine kicked in yet

Enjoy the classes, I did, it was very informative & very interesting to see all the different types of people who come down with it. During discussions I could see who was really struggling with accepting it & who was trying to get as much info they could to make life easier.

I will say, I've been overweight my whole life & at 43 & watching carbs with the diabetes & walking when my numbers get a little high, I lost 30 pounds. So I'm a little thankful. it was a big wake up call for me.

Best wishes

GabbyPA 2010-06-07 15:15:15 -0500 Report

Whom ever you can get an appointment with first. That is where I would start.

Your educator cannot (or is not supposed to) help you with meds. They are to teach you what your body is doing. I loved my classes. They helped me greatly. I cannot see an endo because even if I pay them in cash, they will not take me. I have to have insurance. (how stupid!) It is the best care if you can have both and if both are working for your best interest.

PRP 2010-06-07 16:29:58 -0500 Report

Hi Gabby,
I understand that the educator will not help me with my meds. I was hoping he/she will tell me if I am making a mistake by refusing to take the meds and relying on diet and exercise as a way to control my levels. My only fear after reading Dr. Bernstein's book is that even one or two days of elevated sugar levels can cause damage to the pancreas. But now I have to research and find out which of the nutritionists in my insurance network are certified. I can only visit providers listed in my insurance directory. I cross checked the list from with my provider list and found only 2 were on both lists. Upon further research I came upon a document that listed that one of them did not get recertified in 2008. So I am still searching. I dont know if I just should start calling Nutritionists in my providers list and ask them if they are certified. I don't know whether that is too rude and not civil. I am still trying to figure out how to find a CDE who is on my insurance list.


GabbyPA 2010-06-08 09:13:46 -0500 Report

You know, I would bite the bullet and pick on that you pay for. I don't have insurance, and the one I went to was run by TCOYD and it was a 9 week class. I paid $75 for it and it was worth every penny. I also got a $25 book and a visit with a nutritionist to set up my personal goals included in the price, plus all my literature. I found it through the hospital and I had to wait 6 months to get into the class, but it helped me so much!
So don't settle, find one that you like. The price is not so bad and maybe you can save up money to go.
If you would like to see some of the things I learned from my classes, I have them posted here. I have 7 all together

Emma2412 2010-06-07 10:03:30 -0500 Report

I agree with Diane. See your primary and take it from there. Get him/her to recommend somebody so you won't have any trouble getting it covered by your insurance company. I never do anything without a script from my primary insofar, that is, seeing somebody else (even a diabetes class).
Don't you hate insurance companies?

PRP 2010-06-07 12:09:10 -0500 Report

Luckily, with the kind of insurance I have and according to our state law concerning diabetes, I found out that I don't need a referral from my PCP for any diabetes specialist. I double checked and triple checked with the Insurance company benefits coordinator. The reason for the urgency is that, even though the PCP wanted me to start on glucophage, I am trying to see if I can control it with diet and exercise. In the meantime I am scared of whatever damage I might be doing to my pancreas by having these high sugar levels. If medications are a must, I would like to start ASAP.


PRP 2010-06-07 09:44:19 -0500 Report

Thanks Diane & Greg,

I will be seeing my PCP pretty soon, but I am not that happy about them. It is a group practice and I get one random doctor from the pool whenever I visit them. I like one of the doctors but I cannot make an appointment to keep seeing her all the time. Last time when I saw one doctor he immediately prescribed Glucophage 2 per day. I wanted to wait until I met with a dietitian and the next day the one doctor I liked called me back and asked me not take 2 a day but just 1 a day. When I told her about my plan about diet and exercise, she asked me to try it. With all these experience I am not hopeful I will get good answers. After I started my diet and exercise, my fasting levels have come down from 140 - 150 to 110 - 120. But the frustrating or may be interesting thing is the my 2 hr postprandial levels are always around 120 except in the morning after breakfast it is around 125-130. This is just one example of things I am trying to grasp. But I am not able to make head or tail out of this. I have been reading many books and getting different theories on how to interpret the results and also how and why I should control my sugar levels. So I thought if I talked to somebody whose specialization is diabetes instead of generalized internal medicine I might better answers.

kdroberts 2010-06-07 10:39:39 -0500 Report

If you do see an endocrinologist, make sure they are one who specializes in diabetes and not other endocrine areas that you don't need.

ccritch 2010-06-08 09:31:51 -0500 Report

I agree and you can check to see on the computer what type of endocrine he/she is and what credentials and if board certified. Trust me you don't want to get stuck with one that just says raise then lower, call me 2 wks and you never get to speak with them just the secretary and she said he said raise and lower agains! that does not help at all. Please make sure you get the right care you need It is your life and you are allowed to pick and choose.

kdroberts 2010-06-07 09:36:47 -0500 Report

Diabetes educators are very well educated on diabetes and work closely with endocrinologists. If you can, call up a local hospital system and ask if hey do CDE/endocrinologist combined visits. One morning and one afternoon a week my CDE is attached to my endocrinologist. I see the CDE first and talk about things then she talks to the endo and then I talk to the endo about things.

If you have trouble getting an appointment quickly with any doctor, make any that you can and then call every day around 11:00-2:00 and see if anything has opened up due to cancellations or a change in the doctors scendule. You should be able to get one within a few days of trying.

PRP 2010-06-07 12:13:35 -0500 Report

Thanks. I found 2 Nutritionists on my insurance network who are certified diabetes expert. May be I will call them and set up my first appointment and If I like them I will ask whether they work with any endo and go that route.

gregsteele 2010-06-07 09:09:08 -0500 Report

Diane is right on an endo could take awhile to get in talk to your pcp and get a referal to a certified educator they are very help ful i started knowing nothing in no time i knew enough to keep some control of my b.s. but im still learning how to control not sure we ever quit learning i hope not but see a CDE asap love to all GREG

Diane987 2010-06-07 08:58:34 -0500 Report

If where you live is anything like where I live you won't be able to get an appointment with an Endo for about a month or two. A diabetes educator will certainly be able to anwer questions but you really need to be communicating with your primary care physician.

ccritch 2010-06-07 12:33:36 -0500 Report

Isn't that the truth! Endocrinologist won't see you for 3 months you could die in 2. I say find a doctor who is educated in Diabetes and get them to refer you to the endocrin asap they can usually get you in faster than you trying. A Diabetes educator isn't bad way to go just make sure your primary doctor is up to date on everything with your diabetes. Good Luck and God Bless

katerick3055 2010-06-28 13:33:00 -0500 Report

it's true, a good endo is hard to get in to see. but I found a good nutricianist/diabetes specialist who really has helped. i now count carbs and take my insulin accordingly, keep a food diary (this is mandatory for me), and if i have any questions she's only a call away. my endo is also great & works well w/my sugars had been 300-400 range, and now,(w/a few exceptions) under 150! I still have lots of weight to lose, & lower numbers to get to, but a1c has gone from almost 11 to 7.5. but I have a lot of support, & if cheeseburger annie here can do it, so can you!!! best of luck!

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