How does an endocrinologist treat diabetes?
If you have diabetes, there’s a good chance that you have a team of healthcare specialists to help you stay healthy. Your team might consist of your primary-care provider (which could be a physician, a nurse practitioner or a physician’s assistant), a diabetes educator, a dietitian, and maybe a cardiologist, nephrologist (kidney doctor) and/or neurologist, as well.
Many people with diabetes also have an endocrinologist as part of their team. But what exactly is an endocrinologist? What does an endocrinologist treat? And should you have an endocrinologist as part of your team? Let’s get these questions answered for you!
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Endocrinologists for diabetes: What is endocrinology?
To understand what an endocrinologist is and does, it helps to first learn a bit about the branch of medicine called endocrinology. “Endocrinology is the specialty of medicine that deals with the problems, diseases and medical conditions of the endocrine system,” according to the American Medical Association. OK, but what is the endocrine system? The endocrine system is a network of glands (organs that secrete substances) that produce hormones to regulate a number of bodily functions.
Hormones are released in one part of the body, travel through the bloodstream and have an effect on another part of the body. Examples of bodily functions controlled by hormones include:
- Respiration (breathing)
- Metabolism
- Growth and development
- Reproduction
- Blood pressure
- Heart rate
- Appetite
- Movement
- Sleep
Some of the glands in the body that make and secrete hormones are the:
- Pituitary gland, which makes hormones that regulate growth and reproduction
- Thyroid gland, which regulates metabolism
- Adrenal glands, which produces hormones that regulate blood pressure, heart rate and the stress response
- Pancreas, which produces hormones (e.g., insulin and glucagon) that regulate blood sugar levels
What exactly do hormones do? They’re basically chemical messengers that travel in the bloodstream to tissues or organs. And they’re pretty powerful in that it only takes a small amount of a hormone to cause a change. Hormones that you might be familiar with include:
- Adrenaline: this increases heart rate, blood pressure and metabolism in response to stress
- Cortisol: known as a stress hormone, this raises blood sugar levels, controls blood pressure and reduces inflammation
- Thyroid hormone: this regulates metabolism
- Estrogen: this helps develop and maintain the reproductive system
- Testosterone: this regulates sex drive, bone and muscle mass, and the production of sperm
- Insulin: this lowers blood glucose levels
- Glucagon: this increases blood glucose levels
What does an endocrinologist do?
Now that you have a better understanding of the endocrine system, it might be clearer as to what an endocrinologist does. An endocrinologist (often called an “endo”) is a specially trained doctor who diagnoses and treats conditions that affect glands. An endocrinologist completes additional training after finishing medical school.
People are referred to endocrinologists for a number of reasons, as they treat diseases resulting from an imbalance of hormones. These diseases or conditions include:
- Hypothyroidism or hyperthyroidism
- Polycystic ovary syndrome (PCOS)
- Addison’s disease
- Cushing’s syndrome
- Infertility
- Osteoporosis
- Metabolic disorders
- Certain cancers of the endocrine glands
- Diabetes
Some endocrinologists may treat any number of endocrine conditions, whereas others may have a primary focus, such as diabetes.
Who should see an endocrinologist?
It might seem only natural that everyone with diabetes have an endocrinologist as part of their healthcare team. But not everyone needs to have an endocrinologist and, unfortunately, there are too few endocrinologists to go around, especially since there are 34 million people in the U.S. who have diabetes. According to the website Statista, the number of endocrinologists in the U.S. in 2020 is 8,237, whereas the number of radiologists is 48,464. For this reason, not everyone with diabetes in the U.S. has easy access to an endocrinologist, so some must rely on their primary-care provider for their diabetes management.
The American Diabetes Association encourages most people with type 1 diabetes to see an endocrinologist — at least, when they’re first diagnosed. But what if you have type 2 diabetes? David Erani, MD, an endocrinologist at Onduo, says that “If you have type 2 diabetes and your A1C is higher than it should be or you are having hypoglycemia [low blood glucose], you could benefit from seeing an endocrinologist.” Other reasons to consider working with an endocrinologist include:
· Your primary-care provider doesn’t have much experience in treating diabetes or you feel like your provider isn’t listening to you
· You’re finding it increasingly difficult to manage your diabetes
· You want to learn about other ways to manage your diabetes, such as trying a different medicine, or trying pump therapy, or continuous glucose monitoring
· You have complications from diabetes
Finding an endocrinologist
If you and/or your primary-care provider think that you could benefit from working with an endocrinologist, your provider will likely be able to recommend someone that he or she knows or at least refers other patients to. Your health insurance is also another source for finding an endo (and you may need to stay within network, too).
Other resources for finding an endocrinologist in your area include:
You can also check with your local hospital or call the American Diabetes Association at 1-800-DIABETES or visit www.diabetes.org. You can ask about diabetes programs in your area, which will likely include an endocrinologist that you may be able to see. Check with your health plan regarding coverage.
Preparing for your endocrinologist appointment
You’ve got an appointment scheduled with an endocrinologist. But before you show up, make sure you’re prepared so that you get the most out of the visit. Erani has some pointers. “Controlling blood glucose levels is a big part of managing diabetes. Since you can’t manage what you don’t measure, monitoring your blood glucose closely in the time leading up to a visit is very important.” Also, he advises people to make sure they know exactly what medicines they’re taking (bring a list with you to the appointment) and think about questions you have before the visit.
Speaking of questions, don’t be shy about asking them! If you’re taking the time to check your blood sugars, you might want to ask your endocrinologist, “Why should I do all of this?” adds Erani. Don’t forget to ask general questions, such as when and how often to check blood sugars, how to take medicines, what tests and exams you may need, and what are newer ways of treating diabetes that might be appropriate for you. Your endocrinologist may also recommend seeing a certified diabetes care and education specialist or a dietitian who specializes in diabetes, for example.
During your visit, the endocrinologist should ask you how you’re feeling, how you’re managing your diabetes, and what challenges you may have. He or she may do a physical exam, and will likely check your blood pressure and test your A1C, blood glucose, cholesterol and urine. The endocrinologist should review your blood glucose data, as well, either from written logs that you bring, your meter that is downloaded, or your CGM. You may be started on diabetes medicine, including insulin, or you may be put on a different medicine. Or your medicine may stay the same. You might also be started on medicine for your blood pressure or cholesterol, as well. The endocrinologist will also discuss if and when you need a follow-up visit.
Finally, remember that your “endo” is part of your team. He or she does not replace your primary-care provider. Managing diabetes can be challenging; having a supportive team that includes an endocrinologist can make it a whole lot easier for you.
Want to learn more about your diabetes care team? Read “Your Diabetes Support System” and “Diabetes Management: It Takes a Team.”
