Seeing an Adult Diabetes Specialist (Endocrinologist)
What to Expect from a Visit
At each appointment, a medical assistant will download the data from your blood glucose
meter, insulin pump and continuous glucose sensor (if you use these
devices). The endocrinologist will review them so they can evaluate patterns with your blood glucose throughout the day.
Your endocrinologist uses the American Diabetes Association Standards of Care. These guidelines provide a starting point for a dialogue with your endocrinologist that will work with you to adjust your diabetes medications, evaluate your blood glucose levels, blood pressure, cholesterol, along with the health of your kidneys, eyes and feet.
Your endocrinologist may adjust the medications you are taking, ask you to meet with a diabetes educator or take a diabetes class. Your doctor will arrange for lab tests you need and talk with you about how to keep in touch between doctor visits. You can view your test results using MyChart or we can send your test results by mail.
It Takes a TeamDiabetes care takes a team. This team includes your endocrinologist, dietician, nurse, family and other supports systems. We strongly encourage our patients to engage their family/support systems in their care by having them attend educator visits to provide support in the day-to-day care of diabetes.
When you have diabetes, keeping track of what you eat and drink is very important for managing your condition. Your doctor may ask you to see a dietitian, a health care provider who specializes in helping people eat right to stay healthy. You may ask your doctor about seeing a dietitian if your doctor does not mention it.
First, a dietitian will talk with you about your eating habits, and how your eating can affect your blood sugar and other conditions like high cholesterol or high blood pressure. Next, the dietitian will help you create an eating plan. This might include learning about portion sizes, carbohydrate counting, label reading and meal planning for weight loss. You can also learn how to cut down on sodium, trans fats and saturated fat. This will help you control your blood pressure and cholesterol. Your dietitian can also talk with you about physical activity to help control blood sugar.
Blood Glucose Meters
When you have diabetes, it's vital to monitor your blood glucose values. To do this, you will take a small blood sample, then put a drop of blood on a test strip in a blood glucose meter. The meter will tell you how much sugar is in your blood. At our center, a certified diabetes educator can show you how to use the blood glucose monitor that is best for you.
Prior to 1922, the discovery of diabetes was feared since it would lead to death. The discovery of insulin in 1922 transformed the lives of people with diabetes (learn more on the discovery of insulin). Insulin is essential to people living with both type 1 and type 2 diabetes. Type 2 diabetes is a progressive condition so many individuals may need to transition from other pill medications to insulin over time. This is often felt as a failure to many people living with type 2 diabetes, but medical researchers and diabetes specialist know this is not the case. Taking insulin simply allows for better blood sugar control and a healthier longer life when other medications are no longer effective.
An insulin pump is a device (smaller than a smartphone). It delivers insulin through a small tube (catheter) that is placed under your skin. The potential benefit of using an insulin pump is it's ability to deliver small precise amounts of insulin which provides similar functions of pancreas, but with the person living with diabetes still needing to test their blood sugar and enter information into the pump to help maintain blood sugar control.
If you and your doctor agree to move forward with using an insulin pump, you will have a series of diabetes education appointments. At your first appointment, your educator will show you the types of pumps available and their features. You will also see a dietitian to ensure your understanding of carbohydrate counting and insulin to carb ratios. Once you have received your pump, the diabetes educator will schedule meetings to educate you on how to effectively and safely use your pump.
In the weeks after receiving your pump, you will have your diabetes educator's pager number. If you have any questions or problems, contact your diabetes educator immediately.
Continuous Glucose Monitoring (CGM) Device
Foods with carbohydrates, stress, exercise and diabetes medications such as insulin or Metformin can cause your blood sugar to rise or fall. Checking your blood sugar frequently with your blood glucose device creates one way to understand what affects your blood sugar. A Continuous Glucose Monitoring (CGM) device provides both immediate real-time information on your blood sugar while also providing data on blood sugar trends throughout days, weeks and months.
Continuous glucose monitoring uses a sensor, a transmitter and a receiver. The sensor is a tiny electrode placed just under your skin, often in your abdomen. The transmitter is about one inch long and one inch wide. It is attached to the sensor. The receiver is a separate device, about the size of a cell phone, that you can carry in your pocket or clip on your belt. The sensor measures glucose levels in the fluid around your cells. This is different from measuring the sugar in your blood. The sensor will measure your glucose level every few minutes during the day and night. It sends this information to the receiver so you can monitor your blood sugar. There are two types of sensor systems - one for people who do not have an insulin pump, and one that works with your pump if you have one. If you have an insulin pump, you will not need a separate receiver.
If you have a glucose sensor, you will still need to test your blood sugar with your blood glucose machine. This is because the glucose sensor needs information from your blood sugar readings. Your doctor will ask you to enter information three or four times each day.
If you and your doctor decide to try a continuous glucose monitoring sensor, you will meet with a diabetes educator. Your educator will place the sensor on you and show you how to use it. Sensor visits usually last 60-90 minutes.
Diabetes Education Classes
At the Harold Schnitzer Diabetes Health Center, we can teach you everything you need to know about diabetes and living a healthy lifestyle. We offer classes for people with type 1 diabetes, type 2 diabetes and prediabetes.