Endocrinologist or GP?

Eversinging1
By Eversinging1 Latest Reply 2010-12-29 17:16:06 -0600
Started 2010-11-27 20:17:43 -0600

So I've just now gotten to the anger part. Really ticked off that I have this disease…I am over the denial part. So I made a doc appt but can't get in till Dec. 22 (GP) I know that an endocrinologist is supposed to know all about diabetes but what will he/she do that my GP won't? Oh, I'm type 2, not on any meds..been in denial for over a year, but now ready to learn what I need to do cause I don't like feeling the way I feel. Got scared Thursday when my BS spiked to 308. Highest it has ever been. Any info is appreciated!
Thanks in advance!!


39 replies

Eversinging1
Eversinging1 2010-12-27 08:06:30 -0600 Report

Wow, he must be really good. I'm in Oklahoma and after talking to my doc I'm going to stay with him. Once I opened up to him about what was going on with me he's gotten on the ball and we're working this out together. My numbers and attitude have improved!

Life Saver
Life Saver 2010-12-27 04:06:44 -0600 Report

Certainly go and stay with a good diabetes doctor. What state are you in? Dr Joe Prendergast is a California diabetes doctor that has patients who fly into see him from all over the USA and even outside the USA !!!

Type1Lou
Type1Lou 2010-12-01 14:54:28 -0600 Report

Go for the endocrinologist, especially at this stage in your history with diabetes! Their practice sees more patients with this condition and they generally have a better grasp of treatments. It's good that you're no longer in denial and realize that you have to take action to control this or it will control you.

After moving to Florida in 2005, I had been seeing a GP only. After 34 years with type 1 diabetes, I started having scary morning lows and what had been working for me before was now creating problems. I had to ask my GP for an endocrinologist referral because I just didn't feel comfortable with what he was telling me to do-increase Lantus and eliminate dinner Novolog- (and because I didn't feel what he suggested made sense, I didn't do it.). After waiting 2 months to see the endocrinologist, I just got back from my first visit. This endocrinologist suggested several changes in my approach to insulin that made sense to me (sliding Novolog dosage and changing Lantus from bedtime to morning injection). I've been watching my carbs but will have to seriously count them and dose appropriately to get back under control. Even though you may not be insulin dependent like us Type 1's, an endocrinologist has greater knowledge about diabetes and how to treat it effectively and avoid those nasty complications.

You may also want to read Suzy Cohen's "Diabetes Without Drugs". My husband asked me to read it and I expected not to like it. I have it on loan from my local library. I found it engrossing and thought-provoking. I feel it is perhaps more geared to Type 2's but Cohen, a pharmacist, is gung-ho on natural supplements that may help to lower blood glucose and help your body better manage the disease. I may even try some of her suggestions…wonder of wonders!

Good luck to you!

Armourer
Armourer 2010-12-01 01:27:34 -0600 Report

It took an endocrinologist to find that my GP had missed the warning signs, and he put me on insulin. I changed docs, but kept the endo too. After 1.5 years I dropped the endo cause I couldn't afford him and the GP, who tries hard. But the one medical person that has really made the difference was the diabetic educator diet. person that I see quarterly. Best of luck!

Dev
Dev 2010-12-07 18:37:50 -0600 Report

I was curious how the diabetic educator help you quarterly. I was under the impression that ones they tell you what are the diet rules you need to follow, they have nothing much to say.

CaliKo
CaliKo 2010-12-08 09:05:00 -0600 Report

As you know, diabetes is a complex disease with many stages and possible side effects. Even if we are doing everything right, our treatment and approach to self-care changes through the years as we age and the disease progresses. A good CDE can help you adjust your regimen to your changing needs, and is another health care professional asking the right questions and noticing changes or concerns that may need to be addressed. It's good to have followups from time to time, how often depends on your individual needs.

Armourer
Armourer 2010-12-08 01:00:43 -0600 Report

Mine sets my diet, monitors my BG, and gives meds changes to the doc, to give to me. Done more really then any doc has for me. I saw her bi-weekly, then monthly, and when BG under control to quarterly.

Elrond
Elrond 2010-11-29 22:08:05 -0600 Report

Just to add my two cent's worth. I'm a VA patient and they had me seeing a GP nurse practitioner for my diabetes for a very long time. My BS was constantly out of control, cycling between 50 and 500. I would plead with my nurse practitioner for help and she didn't seem as if she had any idea what to do. My A1C was around 15 and I could see myself headed for an early grave. I finally bugged my nurse practitioner enough that she handed me off to an endocrinologist. Within 6 months, my A1C was 7.5 and a BG below 100 or above 200 was extremely rare. My endocrinologist has me on an insulin pump now and I'm just about due for my next A1C test. I'm really looking forward to seeing the numbers.

Eversinging1
Eversinging1 2010-11-30 08:14:34 -0600 Report

Wow. My co-worker is on an insulin pump. He's a brittle diabetic. Every day, even with the pump, he fluctuates quite a bit.

QueenJeanne
QueenJeanne 2010-11-29 15:46:26 -0600 Report

Eversinging1, you must get over being angry. You first must go to your GP who will check you out and ask him to recommend an endocrinologist, specialist in diabetes and other organs dealing with the endocrine system. You will hurt yourself if you do not go and get taken care of. I have lost three cousins, in the same family, who lost limbs, kidneys failed, eyesight lost and a new one, skin began to separate from her body. This is not a disease to play with. This will kill you early if you do not get a handle on it immediately. I do not mean to be rude or anything, but your life is at stake and I personally want you to live as long as you can. I have an aunt who is 85 years old and she has lived with her diabetes all of her life. So take care and I will be checking up on you in the future.

Eversinging1
Eversinging1 2010-11-29 17:52:54 -0600 Report

Girl, don't know why your post got to me the most, but between that and my bro in law today being told he has to go on insulin, I changed my doc appt to next Monday. I'm not going to wait another month to find out what condition I'm really in and get busy on taking care of this mess! I've been reading lots of posts around this site and another thing that stuck out is that so many of us, by refusing to do what we know we need to do, are being self-destructive. I had never thought of it that way before. But I am constantly sabatoging myself and I need to quit. geez…slap slap slap ! thanks for your post.

QueenJeanne
QueenJeanne 2010-11-30 10:37:02 -0600 Report

Eversinging1, people love you and want you to be around. That's what was told to me by my great nephew who loves me to death. So you must take care of yourself and teach your bro-n-law to do the same. This diabetes is nothing to play with when it comes to your life. Take care and I will continue to check up on you to see how you are doing. By the way, I want to inform you that I take three different medications for my diabetes and my readings this morning were 132 upon waking up this morning and 88 at 9:30 am. Will be taking two more readings before the end of today. This is what an individual must do to keep everything in check and to stay alive. Peace and Love.

norris
norris 2010-11-29 15:02:21 -0600 Report

Norris Neal I'm in a similar state as to what doctor should I go to. I know that gp's will try to handle this but I do believe that a specialist should be involved. Any one out there with a similar problem let me know what one should do. thanks

ELDER GREEN
ELDER GREEN 2010-11-29 13:50:32 -0600 Report

The information already given is priceless. I went to the emergency room several yeras ago because I was feeling bad. My BS was at 400. I did what the others are saying. I primarily go through my primary doctor. I am sometimes bothered that he hasn't said anything to me about losing weight especially after some other issues I've had lately. His way of thinking is the patient knows they need to lose weight so he doesn't press them about it. My wife says he maybe do not want to offend the patient. I saw a dieticiian when this first happened but I did not follow it through. I have been taking meds thus far. My levels are doing fine right now.

CaliKo
CaliKo 2010-11-29 10:11:40 -0600 Report

Hello, Eversinging,
I've been diagnosed for two years now, T2, and am diet and exercise controlled. My internist that I was already seeing for high blood pressure is also monitoring my diabetes, and doing all the right things. If your doctor refers you to a CDE class, or appointment with a dietician, runs all the tests a diabetic needs - starting with regular A1Cs every three months until you are stable, lipid panels, etc. etc. and makes sure you are seeing an eye doctor and dentist, and looks at your feet and asks all the right questions, discussing exercise, then you are probably being taken care of okay. If you have any doubts, you should shop around. If my course with DM ever gets complicated, I would expect my internist to refer me to an endocrinologist. Good luck!

Eversinging1
Eversinging1 2010-11-29 13:03:19 -0600 Report

Mine hasn't done anything. He sent me to his diabetic nurse the day after I got diagnosed. She told me the basics of what diabetes is and gave me a meter and showed me how to check my blood. Told me how many carbs to have with each snack and meal, and then sent me on my way. That's the education I got. I've had one A1C test in almost 2 years. I tried talking to doc about my weight and he just told me to exercise. I tried to talk to him about my feet and haven't gotten very far. he's been my doc for several years but I think I'm going to have to go elsewhere.

CaliKo
CaliKo 2010-11-29 13:11:12 -0600 Report

I'd have to agree with you. The follow-through care seems lacking. Your doctor should be your partner in your health care, and you should be having 3-month checkups until all your numbers are good. Then 6-month checkups. If you don't know other diabetics in your area that like their doctors, I'd be looking in the phone book for doctors specializing in treating diabetes that have privileges at a hospital I am comfortable with. Please let us know how it goes, and good luck.

Mrs. Alilce
Mrs. Alilce 2010-11-28 21:32:43 -0600 Report

Likely your GP is great or you would not use him/her. I have two friends who are Endo for children. As a school psych, sometimes blood sugar masks other behavioral appearances. When I would recommend a screen, I told the parents if my kid had to go—this is who we'd go to. Get on-line. My catchment area is Vanderbilt. A teaching hospital has great programs which may be less expensive. When stable, you return to your physician. Bllips along the way, he calls in. The Endo decides if you need to be up there in a hurry. See if your local hospital supports a discussion group. We have access to lunch 1st Tuesdays and dinner 3rd Thursdays. It is casual and we sit together and we talk—family, food, feelings. Now that you have made up your miind, you're going to be great! Friend me Mrs. Alice

Eversinging1
Eversinging1 2010-11-29 08:08:26 -0600 Report

I think there is a support group here but I go to school on Tuesdays and Thursdays so I can't make it. (We're already friends, BTW!!) :)

Mrs. Alilce
Mrs. Alilce 2010-11-29 08:18:53 -0600 Report

Like the Scarecrow—there goes some of me again! Please laugh at my memory cells, we do! We will support you to death, just holler back at us.

regor203
regor203 2010-11-28 20:41:35 -0600 Report

My GP manages my treatment and he does a very good job. He is well educated and somewhat of an over achiever in med school so I trust him. His father was a diabetic so he also knows what it's like to live with it. My BS was 600 when I was first diagnosed but I am sure I had diabetes at least 2 years before that looking back at how I felt. I didn't go to the doctor until I thought I was going to have a heart attack just walking up a flight of stairs at a local store one day. I sat in the isle for 20 minutes before I could get up. I went to the Dr. the next day and was diagnosed with Type 2 and high blood pressure that was 170 over 107. He wanted me to go to the emergency room but I refused and he made me sit in his office for and hour and a half before he felt comfortable enough to let me go. When my blood work came back my cholesteral was 508. Needless to say I was feeling pretty crappy for quite some time but he had everything under control in a few weeks. He wanted me on the shot but I opted for the pills. All of my numbers are good now and I don't have to see multiple doctors to do it. Good Luck.

Eversinging1
Eversinging1 2010-11-28 21:04:56 -0600 Report

Wow. My brother in law is going to doc tomorrow. he had an episode yesterday and I checked his bs and it ws 560. Made him stay till it came down. He refused to go to ER. Scary stuff.

norris
norris 2010-11-29 17:28:27 -0600 Report

Eversinging, I thought I was in trouble when my BS was around 186 to 200. I thought one would go into a diabectic coma when it was that high. Good luck.

Eversinging1
Eversinging1 2010-11-28 20:27:57 -0600 Report

Ok. I was wondering if my doc was dropping the ball. Just doesn't seem like he even remembers I'm diabetic! Thanks for all your responses!

BandonBob
BandonBob 2010-11-28 13:42:54 -0600 Report

I went through a spell when I thopught maybe I should see an endo and my Primary care doctor gave me a referral to one who was highly recommended. I was astounded when he endorsed all the treatment that my regular doctor hed orescribed for me. It did give me real peace of mind because I was worried about the progressive nature of diabetes and thought my doctor might be missing something.

alanbossman
alanbossman 2010-11-28 13:12:42 -0600 Report

Hi and welcome to DC family i do not see a Endo, i see my GP who takes very good care of me. He is up to date on all the diabetic treatments. i am in control of my BS.
Alan

Gabby
GabbyPA 2010-11-28 08:43:21 -0600 Report

The most important thing in finding a doctor is finding one that you feel comfortable with and who is working with you to treat your disease. The GP may not have all the answers, but if they are willing to learn along with you that is far better than an Endo that you cannot get a long with. Now Diabetes is very complicated and it is a good idea to have someone who is up to date on all the latest research and usually that would be your Endo. But if you choose and Endo, make sure their specialty is diabetes, as there are many diseases that they specialize in.

Glad to see you are taking the next step. It is hard, but it is going in the right direction.

jayabee52
jayabee52 2010-11-27 21:21:54 -0600 Report

Howdy Nancy.

I'm glad to hear of your progress with the stages of grief and that you are moving to get on top of your DM.

Regarding your question of GP vs Endo, usually you have to be referred to an Endo by a GP or Primary care Dr. Generally speaking it also takes longer to get into an Endo as they're often booked farther out.

Perhaps at your stage of DM, the services of an Endo might be a bit of overkill.
I use a Primary Care Dr to manage my DM, because my DM is relatively simple and stable . My bride, however needed an Endo because her DM was more severe and complicated by other conditions. Her Endo was able to put her on insulins which helped to lower her BG#s At some points her BG#s were higher than our meters could read. At that point we brought the Endo into her treatment plan. He helped us to get better control of her BG#s.

So it would probably be best if you were to keep the appt. with the GP, and you can discuss the possible need for an Endo with Dr.

Regarding the long wait, if you have the flexibility, you could call the Dr office every day and ask if there have been any cancellations and offer to take the open appt. time.

Blessings to you and yours

James

Dev
Dev 2010-11-28 17:15:39 -0600 Report

that was very helpful James. I was wondering if we should move to a GP or a primary care Dr. for my husband. But wasn't sure who to ask.

The Endo does not have appts and no time when we actually see or call to enquire something. Never explains why she is giving meds or their side effects or other options. Also, if you ask her about something that is bothering you she just says, oh that is not because of diabetes and does not say anything more. I am assuming a Primary care physician would help with respect to overall health.

*sigh* I have been in US for five years now but I still don't understand how medical system works here.

regor203
regor203 2010-11-28 20:53:46 -0600 Report

Hi Dev, I am sorry you are not getting the answers you need from the Endo. My GP manages my treatment and I see him twice a year unless I need to see him for something else. He always takes time to explain everything with me. He spends more than an hour with me when I see him and we go over everything past, present and what I need to do in the future. He makes sure I get my eyes checked every year and also checks the pulse in my legs and feet. he check every detail that could possibly be a future complication. Maybe you could express your concerns to the GP and see if he would be comfortable managing treatment. Good Luck.

Eversinging1
Eversinging1 2010-11-28 21:06:06 -0600 Report

You have an unusual doc! I'm lucky if mine stays in the exam room over 5 mins. I take list with me but he's always rushed to get out.

regor203
regor203 2010-11-29 19:55:02 -0600 Report

You need to find a new Doctor. I will admit that I got lucky when I found my doctor as I am sure is a rare find. Because being a doctor is no longer a profession but an industry that above all needs to make a profit. Mostly the insurance companies are to blame since they pay less than half of the doctor charges so they try to make it up in volume. Plus he knows I don't play that game. If he gave me 5 minutes time then he would get 5 minutes pay. He also knows if he leaves me waiting more than 15 minutes in the waiting room then chances are I am gone. My time is valuable too.

Harlen
Harlen 2010-11-27 21:17:44 -0600 Report

I would go GP first and then if you cant get you BS inline then you may need a endo.Just know that I am not a Doc
Best wishes
Harlen

Kirla
Kirla 2010-11-27 21:15:32 -0600 Report

I post my story for new people or people who need to control their blood sugar to have a place to start. When diagnosed I didn’t know what to do and was afraid for what was going to happen to me. I believe most people with type 2 diabetes can learn to control their blood sugar and get off meds and insulin if they just eat right and get a little exercise in.

I recommend researching the low carb diets and picking the one you like the best and feel you might enjoy the most. I kind of follow the Atkins diet myself. Once you get your numbers down you can always modify it to include foods that don’t spike your blood sugar. I kind of started in phase 2 of the Atkins diet because I wanted to include lots of vegetables and soon found that nuts and seeds don’t spike blood sugar much, if at all. Just watch the servings. Otherwise you’re going to gain weight eating nuts and seeds all the time. I have a feeling you all ready read my story, but if you didn’t here is basically how I started to control my blood sugar. This was what worked for me. It may or may not work for you. I just don’t see any harm in drinking 8 plus glasses of water and following a low carb diet until you get a chance to test the foods you eat and come up with a plan that works for you.

Feb 2009 I was diagnosed with a fasting blood sugar of 366 and A1C of 14.1. Started to eat a salad every day at supper. Also started to eat lots of low carb vegetables like broccoli, cauliflower, cabbage, cucumbers, spinach, pickles and sauerkraut. Started to drink 8+ glasses of water every day.

I then bought a meter and started to test my blood sugar before and after each meal. At first I was testing 2 hours after each meal and when my numbers dropped a lot I started testing 1 hour after meals.

By testing I found that foods like bread and most foods made of grains along with pasta, rice, corn, potatoes, oatmeal, cereals, chips, crackers, cakes, cookies, candy, soda, fruits, fruit juices and most foods that contain more than 5-6 net carbs per serving as found on the package label all spiked my blood sugar. Some people can cut back on these foods and some people like me have to stop eating them.

After about 6-8 weeks my blood sugar readings were almost normal levels. After 7 weeks I quit all meds and my numbers continued to get better and better.

I found by reducing and eliminating high carb starchy foods helped me a lot. By adding small amounts of chicken, beef, pork or a hard boiled egg to my meals helped reduce blood sugar spikes also.

Good luck
Kevin

Weather to see an Endocrinologist or GP would depend on your insurance company. If they cover it you may want to see the Endocrinologist. I read somewhere that not all Endocrinologist specializes in diabetes. I never seen one myself. I had a GP and he wasn’t much help. Just gave me lots of pills and some advice on what not to eat. Wasn’t much advice at all. Learned a lot more off the internet than I did from doctors.

ELDER GREEN
ELDER GREEN 2010-11-29 13:41:35 -0600 Report

This is very informative. I too, want to be able to get off the meds. Ihave begun losing weight by walking and modifying my diet. I need to do more in both areas.

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