Endo vs. General Physician?

Just wondering what people’s thoughts are on this issue… I’m a Type 1 and was diagnosed almost 6 years ago. I’ve never seen an endocrinologist and get a lot of flack from people on this issue. However, my current physician is a Type 1 diabetic himself and I feel comfortable with him as he knows first hand what it’s like and what issues we face. Should I still consult an endo despite this? What are people’s thoughts on the benefits of seeing an endo specifically? Thanks!

For me seeing an endo is better because I also have Hashimoto’s. Plus I have access to a nurse who is a CDE if I need help with my basals or if I am getting sick. My endo also is well versed in all the pumps on the market so I get excellent pump support and additional training if I want it. There is also a nutritionist on staff who helps me as I am still kind of new at carb counting. So for me it is about the total care experience and support as I use a CGMS and a pump. So if you are comfy on MDIs and don’t want a pump then I don’t see why you can’t stay with this doctor. I assume that he keeps up with the latest and greatest things going on in the diabetes field since he is diabetic so I think it is OK. If you don’t think he is keeping up with the trends, then see an endo once or twice a year and keep this doc as your GP. I am sure others will have a stronger stance on this and say you should see an endo no matter what, but you have to feel good about working with your doctor.

I have never had a doctor who was diabetic, t1 or t2! That is kind of neat!

In my personal opinion if your doctor is up to date and very well informed on the subject there is little need to see an endo. Your average run-of-the-mill family doc is like a Jack of all trades, master of none. If your doc however takes good care of you and seems to have answers for all your questions I think you’re fine.

Keep in mind though that just because he is type 1 and a doc doesn’t mean he’s the most qualified to treat other diabetics. My father uses an example from his own experience for situations like these. He use to see a doc, back in Greece, who would lecture him mercilessly about smoking. Whenever my father saw him the doc would have fresh pamphlets with information about the harms of smoking. He would show him pictures of lungs that used to belong to a smoker (black and shriveled). He would do all of this and in the mean time chain smoke through the appointment. He died of lung cancer a few years later.

I agree with this… my ob/gyn is a T1, but I wouldn’t want him managing my D care… it is VERY nice however, to feel like he at least has some understanding of what I deal with, unlike most OB/Gyns who’s only experience is with GD, which they normally pass on to a perinatologist to handle.

I think though, if I had a GP who was a T1 themselves and very up to date with current treatment options and technologies, and I didn’t have any other endocrine issues (I do) I would probably be fine with seeing a GP who was also a T1… but the real problem with seeing a GP however, is that so many of the people who do, are NOT getting the most up to date medical care possible… almost every T1 diabetic I’ve come across online still seeing a GP for their D care is either on R and N or 70/30 mixed insulin… not exactly the best regimen available, and most of those patients don’t know there is anything better available, or that their GP has failed to inform them that there are better options available.

I have seen all my Endos in the area and wasn’t happy with them. I think any MD with diabetes knows what you go thru better than any Endo who read about it in a book!

i just go to my family dr. he is up to date on everything that is going on and i really enjoy him as a dr. i feel like i can talk to him. i also tried numerous endos. didn’t like anyone. they were all too stuffy for me. i’m a lighthearted person and like to joke around so if i say something i find funny and the endo just glares at me, i never go back. i’ve had several endos make me cry as a teen, leaving a very bad taste in my mouth for them.

I’m glad you like your GP. That’s an important element in your overall health. However, I’m guessing if you asked him if he was “up to date on everything that is going on,” he would be the first to tell you that that is impossible. If he were to specialize in any area, he would have to let other areas slide, and by definition, would be a specialist.

I see my GP regularly. He is 1/2 mile away right here in Wild Rose, WI. However, the first thing he did when I got here was send me to an endocrinologist, who happens to be 75 miles away.

I have a fantastic GP,sent me to an endo because I have more than one prob…and my endo is a T1— and does he ever understand. Also, have a T2 fried who sees him as well–and he is just as understanding. Thre are 4 docs m a PA, CDE in the practice–they all have worn pumps (with saline of course) and GGMS–its required–they’re awesome

After reading your comment/question, my first response was,“My experience has always been that endo’s seem to know more than the GP’s when it came to the diabetes.” I’ve seen A LOT of doctors and of course, I’ve had some bad endos along the way as much as I’ve had good ones. (And I’ve looked for differences in male doctors vs female doctors. I have an inquisitive mind. That’s just me!) Then I read that your GP is a T1 diabetic!! That I’ve never had! (Now I really feel badly that I made a comment once to one of my best and favorite endo docs that he is not a diabetic and doesn’t understand me! I should apologize… Sigh…) In your case, I think you should do what you feel most comfortable. Personally, if I could have a doc which is a blend of GP and Endo, it is the best! I’ve only had this once when I lived in my hometown, a small city now. My long held theory of, “The diabetes affects the body and the body affects the diabetes.” came into play while I had this “blended” doc and having her was one of the best situations for me! I could go to her for any and everything I needed and we could handle all of it at once. I had everything in one chart. Here in LA I can’t find that kind of “blended” doctor, only specialists. So, I see my endocrinologist the most and the others a few times a year. (yeah, I have a lot of other doctors for lots of other things!) I wish you the best!!

he really is up to date on diabetes. he has a lot of diabetic patients. i meant that he is up to date on diabetes, not everything in the medical world although i wouldn’t be suprised. he is a brillant man, very smart, very well educated and is deeply passionate about what he does. he has offered me something no endo has ever offered and that’s talking to me with respect, talking like he was on my side to help conquor what we all deal with from day to day. i’ve had numerous endos tell me “i know how you feel” in hopes of relating to me but it only upsets me because they do not know. he has never once told me that God awful phrase i hate hearing but i really feel sometimes he does in fact know how i feel. i have family members that go to him with other issues. take my father for example. he had a massive heart attack 2 1/2 years ago. he sees our family dr. regularly and has actually stopped seeing a heart specialist because he’s in better heath under our family dr’s supervision than he was with the cardiologist.

my point being if you find a fantastic dr, i stay stick with him/her, whether they are a specialist or not. i’ve choosen to take my health and happiness in my own hands. i choose to do this by seeing my family doctor who has helped me overcome a lot, get things in control, and helps me laugh.

congrats mike!!

i actually see an internal medicine specialist but his son is a t-1 so he’s always up to date on the most current treatments :slight_smile:

I tend to always want my son to see an endocrinologist because I feel there is nothing that I ask that they have not heard before. That being said, i know of an internal medicine Dr. here who has had Type ! for many many years and he has
quite a following of diabetics in his practice. Some of what he has told friends of mine I don’t agree with, but from what I
understand he is great, he wears a pump and seems to be on top of things. As long as they stay current with the latest info and it is convenient for you why not??? You could always see an endo and compare what he says to what you are currently doing and see if there is a difference!! Good luck.

Hi Colleen you have a unique situation however let’s work backwards. Are you happy with your current level of control? This is a relatively easy question to answer however what I am really asking is how much work are you willing to do to? Do you want sugars that are terrible, O.K. or EXCELLENT. Do you live alone (different strategies to STAY SAFE apply). What this all funnells into is how much time and energy you want to put into reducing the potential complications WITHOUT GOING TOO LOW!!!

This is all about staying in a SAFE ZONE and this depends on your lifestyle to provide at very least adequate control, which is tough enough as it is. It is an enormous task for most people to run an A1C of 6%, and ALL the variables are up to you. I always prefer experts no matter what I do, and as a result recommend an Endocronologist. A very interesting question is how well controlled is your doctor, remember they are people too, and as we all know IT’S A VERY TOUGH JOB!!!

You would be surprised at the level of ignorance some doctors have no matter who they are. They are like all professionals some are better than others. The beauty of an Endo is that they are familiar with a number of other diabetics and how they achieve whatever level of success thay have attainted, and can pass that on to you.

The other side is that they are also more aware of different medications that may be better suited to your lifestyle, and psychological approach. They can also help with predicting complications in more detail before, during and after they set in. The bottom line is that you already know your hour to hour, day to day numbers so the rest is fairly predictable.

After thirty five years (type 1), I am doing extremely well and because I don’t fit the typical profile I generally get my family doctor to do the bloodwork (again fairly predictable), and occasionally check with my Endo just to make sure all is still well. If you are curious about some of the things I do, check out Oprah’s Diabetes Support Board at www.oprah.com/community/community/health/diabetes and look for Diabetes The Real Cost by the Anonymous Diabetic. Good luck and I hope this helps.

Love Always
The Anonymous Diabetic.

Thanks everyone so much for your thoughts!! One of the things someone else pointed out that I like most about my GP is that, being a T1 himself, he treats me with respect and doesn’t talk down to me. He says things like “we all know that in the real world it takes more than 5 seconds to actually check your blood sugar” and as we both work in a hospital setting, he is all too familiar with how erratic my schedule is. Having said that, it does sound like a good idea from all the feedback to at least check in with an endo once or twice a year. This is helpful to me as well because I will be moving in the Fall and will have to unfortunately leave the doc I have now (who is great and is the first person I’ve seen who has really helped me get in control). This way I have a better idea of who I should have on my care team when I move to a new state. Thanks again and best wishes to all! :slight_smile:

Internal medicine is the medical specialty concerned with the diagnosis, management and nonsurgical treatment of unusual or serious diseases :slight_smile: that’s the wikipedia definition anyway it sounds about right! He’s awesome he’s been my doc since i was fairly young so there’s a great deal of history and trust. Honestly after some of my experiences with other doc’s i’d go to him even if his specialty was orthopedic surgery :wink: got one of those too from some sports related injuries haha