[beaner293]

By all rights, I have my diabetes well controlled. My sugars are running in the low-80's consistently and I'm getting a handle on which foods spike me and reducing/adjusting my carbs accordingly. As a result, my A1c has steadily decreased from diagnosis to a 6.1. I'm shooting for a sub-6 at my next in March. Thanks largely to my own research, this board and a db education course I'm completing, I feel well informed.

My GP is fairly knowledgeable, but I question his decision not to put me on Metformin at diagnosis (375 mg/dl) and he sometimes "forgets" I'm a diabetic. (I stay on top of it and make sure I ask lots of questions).

So the question is this, is it worth the time, effort and money to meet with an endo and review everything I've done to this point? Since endo's are better trained in the management of the disease, is it worth it? What are the benefits I might get?

Appreciate the input.

 

[jwags]

I don't use an endo because I am not on insulin and like you am fairly well controlled. Since we have to buy our insurance on the individual market, it is very expensive for lousy high Deductible insurance. So we pay the full price of the doctor, lab and Rx until we meet deductible which is $6000. So my internist charges $89, while the Endo would be $400 or more. That is how I make my decision. There is no guarantee that an Endo would give you better care and most are booked up for months and give you much less time at a visit. I think just like GP's and Internist's there are good and bad Endos. I would imagine most push a lot of the newer expensive drugs as opposed to controlling this with food choices and exercise.

 

[foxl]

I needed an Endo, but that is because I had T1.5 and knew insulin was in my immediate future.

I would say if you are happy with your current management and your generalist, save the money and effort!

 

[ThoseBackPages]

endos know tons about diabetes. it may be worth a trip for yourself

 

[Adjitater]

Unless you are having problems don't bother. I have been to 2 endos in my entire diabetic carrer.

 

[jwags]

I was playing tennis today with some other ladies. It was very cold and I had a hard time warming up. One of my partners asked if I had told my Endo about being cold. I told her I have never seen an Endo. She was shocked, her husband is a type 2 and always see an endo. She made me feel terrible because I didn't see an endo. I told her I was very well controlled, most bgs under 100 and very few spikes. I also am a low carber which I know endos don't like. I see an Internist who is a friend and get him to write my Rx's, and write my scrips for labs. That is all I need a doctor for right now. She told me Endos may see things ordinary doctors don't. I felt like telling her to mind her own business. I'm sure I am in much better control than many people who see endos.

 

[Strawberry]

I see an Endo only because he does know more about Diabetes and the insulin pump than my NP does. Because Medicare helps pay for my pump supplies, I am required to see an Endo every 3 months - or at least that is what I was told. So basically all I need him for is to write the Rx for my insulin and pump supplies. He is one of the better ones though because people drive for a long distance just to see him, and he does take time to 'listen' to his patients.

 

[Countrygal]

Ditto strawberry. I just see my endo because in order to get my pump supply RX and a new pump when it's time I have to. But I can tell you a little story of what happened to me when I stopped seeing my endo around a year ago... My primary doc wanted to manage my diab and me to stop seeing my endo. I said, "sure". When it came time to get more glucose strips, I called his office and he called in a strip refill for: testing to be done no more than 4 times a day!!! I immediately called his office knowing this had to be a mistake. Nope, no mistake the nurse said. I said, well you know I am type 1 and on a pump don't you? They said yes but there is NO REASON for a diabetic to test more than 4 times a day! I quickly call my endo and explain what had happened and set up an appt with them asap. My primary wouldn't budge on RX
ing more strips for me and my only recourse was going back to my endo for diabetes care. Can you believe it?

 

[Strawberry]

Countrygal -

Yes, I can believe it because the same thing happened to me......only it happened with my Endo. I received my last shipment of pump supplies and test strips which were sent by the pump company. I called them to inquire why the amount of my supplies was not shipped the same as before? Their response was "Your Endo said you only need "x" number of infusion sets and you only need to test 5 times a day." Called the Endo's office and NEVER did get a call back from the Nurse (who handles all phone questions). So now I have to buy a box of infusion sets online plus my own test strips. Never mind that the insurance company would pay for a few more infusion sets plus more test strips.........the Endo forgot to put the proper amount down on the fax to the pump company - OR - his Nurse forgot too. Each of them could point the finger at the other.

I believe Adjitater has it right "don't bother unless you are having problems".

 

[Countrygal]

Strawberry, unbelievable Im back with my endo but if he tried the same stunt as my primary did, I'd quit and find a new doc.. I'd have to, and that reminds me.. I got a letter the other day from our INS company that they were limiting every diabetic subcriber to 200 strips per month!!! Can you believe that?

 

[Strawberry]

Yep.....I believe that. It must be the trend because of the new health care program our President has deemed best for us.

 

[auto]

I asked the director of the medcenter who I should see, since he has diabetes type two as well. I sent an email to the endo diabetes specialist he recommended and she was willing to see me the very next day. I just met with her a few weeks ago and she seemed quite competent. She sent me an email follow up and copied my GP on her diagnosis. My insurance copay was $35, so for me it was definitely worth it. She prescribed Januvia which is an expensive med, but there is a coupon on line for a free month supply. IMHO it is worth having as much expertise as you can tolerate as this disease is not curable, it must be managed, and I welcome all knowledgeable advice I can find.

 

[righteousdude2]

If You're On Insulin, I'd Endo!

I asked the director of the medcenter who I should see, since he has diabetes type two as well. I sent an email to the endo diabetes specialist he recommended and she was willing to see me the very next day. I just met with her a few weeks ago and she seemed quite competent. She sent me an email follow up and copied my GP on her diagnosis. My insurance copay was $35, so for me it was definitely worth it. She prescribed Januvia which is an expensive med, but there is a coupon on line for a free month supply. IMHO it is worth having as much expertise as you can tolerate as this disease is not curable, it must be managed, and I welcome all knowledgeable advice I can find.

The preferences differ. However, once I received permission from my HMO to an Endo. I got my numbers under control. So, I'm rather biased on the subject. However, I feel if you're on insulin, an Endo is the way to go, if only for periodic consults.

Pastor Paul

 

[birdman]

My PCP dropped my testing also

I don't have an endo in my area, and know I need to see one.
Last month my PCP wrote my Rx for strips at 4X a day, even though I test 8X a day, and my control has been diminishing.
I am looking for an endo in the next nearest town (50 miles) that I can go to. Anyone have recommendations for an endo in Kingman AZ?

Ditto strawberry. I just see my endo because in order to get my pump supply RX and a new pump when it's time I have to. But I can tell you a little story of what happened to me when I stopped seeing my endo around a year ago... My primary doc wanted to manage my diab and me to stop seeing my endo. I said, "sure". When it came time to get more glucose strips, I called his office and he called in a strip refill for: testing to be done no more than 4 times a day!!! I immediately called his office knowing this had to be a mistake. Nope, no mistake the nurse said. I said, well you know I am type 1 and on a pump don't you? They said yes but there is NO REASON for a diabetic to test more than 4 times a day! I quickly call my endo and explain what had happened and set up an appt with them asap. My primary wouldn't budge on RX
ing more strips for me and my only recourse was going back to my endo for diabetes care. Can you believe it?

 

[fiesta]

I am a Type 2 diabetic. I just got my March newsletter. I do not see an endo. I know a lot of people feel that it is the only way to go. That is up to each individual person.

jwags, do not feel quilty. You can get your information on the support groups. I find that I get more direct answers this way. The support group comes up with ideas that I would never thought of asking. Plus, I live in an area of small towns. We do not have an endo within 2 hours of here.

 

[weaveroflight]

My GP sent me to one I'm sorry to say. I'm sure it is the one I went to.
He had my meds so mixed up that it took along time to get back on track.
Endo's jobs are to know about the pancreas so if I had gone to a good one, I know I would have learned much.

 

[fiesta]

I am sure that your GP thought that he/she was sending you to a good one. Your GP probably felt that your health could be taken care of better.

Have you told your GP about your experience? Your GP will check the next one out and get you a better one. You can benefit greatly from an endo. A lot of people do.

 

[Adjitater]

My GP sent me to one I'm sorry to say. I'm sure it is the one I went to.
He had my meds so mixed up that it took along time to get back on track.
Endo's jobs are to know about the pancreas so if I had gone to a good one, I know I would have learned much.

Endos specialize just like all other Drs. do. Not every endo is good at treating both types of diabetes. Some of them don't even see diabetics regardless of which type you have.

 

[Eve]

I was asking this question for awhile and wished I found this forum sooner.

I was diagnosed as a Type 2 two years ago. I was taking oral medications (Met ER, Actos, Amaryl). This past year has been a real struggle to keep my number in control. My morning readings went over 200. In the meantime as the numbers were creeping, I kept telling my doctor (PCP) that I was not meeting my goals, he upped my Metformin by one pill and my amaryl by one pill. It was not working and I was starting to question my doctor and his "passive" approach to treating diabetes.

So I self-referred myself to an Endo on recommendation from a family member who is a nurse. I went to see him this past Monday. I am now having tests run to check if I am actually a Type 1.5 (LADA), he immediately started Insulin Therapy and took me off the Actos.

I am not anti-doctor, don't get me wrong, but I can guarantee you if I stayed with my PCP, I would have continued down the same path for many more months with high readings and my doctor would never consider the fact that I could be misdiagnosed as a Type 2. I should have seen the Endo sooner and wish I did.

I know alot of people that do not go see an Endo, but they also have their diabetes in control and are not on insulin.

My answer would be yes. It will only help you more and they are specialist that keep up. Even if you don't need to see the Endo all the time, it's good to have one in your doctor team.

 

[Shanny]

Welcome aboard, Eve. My relationship with my doc has changed fairly dramatically due to my own management of my diabetes. In two years he has gone from grumping that I test too much and go too low-carb, to now suggesting that my husband continue eating MY way (this after DH's lipids fairly plummeted on my low-carb/high-fat way of eating )! He specializes in geriatrics, has been our doc for many years & we've been through a lot with him. I know he will refer to an endo if I need one, but it will mean traveling, because the nearest one is about 90 miles away. We'll just cross that bridge when we come to it . . .

Sure is good to have you with us . . . thank you for joining us & I hope you have time to visit here often!