Should Everyone with Diabetes See an Endocrinologist?

I was recently diagnosed with type 2 diabetes by my primary-care doctor. Do I need to see a specialist?

In general, if you have uncomplicated type 2 diabetes, your primary-care doctor can manage your diabetes care. But I do recommend, especially for new-onset diabetes, that you ask your primary-care doctor to refer you to one particular kind of specialist—a certified diabetes educator (CDE).

Among other things, a CDE is specially trained to be able to advise you on lifestyle changes, such as proper nutrition and how much and what kinds of physical activity will help you manage your blood sugar and avoid diabetic complications. Having a CDE assist you with these and other time-consuming elements of treatment relieves some of the burden of care from your doctor, who is not likely to have as much time available during a regular office visit. That’s why a CDE needs to be a key part of your health-care team.

Type 1 diabetes is a different story. Anyone who has type 1 diabetes, an autoimmune disorder, should have an endocrinologist on his/her health-care team. An endocrinologist is able to oversee the tightly structured treatment program necessary to manage type 1 diabetes and deal with such things as high-tech insulin pumps, continuous glucose-monitoring devices and so forth.

Some people with type 2 diabetes also should see an endocrinologist. See one if…

• You’re having trouble controlling your blood sugar.

• You and your primary-care doctor are finding it difficult to find the right mix of medications to control your blood sugar without worrisome side effects, including low blood sugar.

• You need to take three or more insulin injections per day or use an insulin pump.

Even if your type 2 diabetes doesn’t include the above challenges, it makes sense to consult an endocrinologist if your doctor recommends it…if your primary-care doctor doesn’t have much experience treating diabetes…or if you feel that there are problems communicating with your doctor, such as questions that aren’t satisfactorily answered.

For more info, check out Bottom Line’s “Guide to Natural Ways to Manage Diabetes” for nondrug therapies that can help you manage your disease.