From Kansas City, Missouri, USA:
About six months ago, I had elevated glucose and cholesterol levels, and my doctor and I agreed I would try to see if I could control them with diet and exercise. However, it wasn't worked, my morning glucose is 150-170 mg/dl [8.3-9.4 mmol/L], and now he wants to put me on medication, which I can understand.
Everyone that I know with type 2 diabetes is seeing a specialist. Should I feel comfortable in letting him prescribe and monitor my diabetes or ask for a referral to a specialist?
Many primary care physicians have a large number of patients with type 2 diabetes. Certainly they have the capacity to manage this chronic condition. Your physician appears to be approaching both diabetes treatment and cardiovascular disease prevention to current standards of care.
If you have not done so already, ask your physician for a referral to an outpatient diabetes education program or a Certified Diabetes Educator/dietitian, so that you can become an informed partner in your management. Learning how to use a glucose meter to pattern your blood sugars throughout the day will assist both you and your physician in confirming or making changes to your management regimen.
If you have a good relationship with your physician, respecting both his medical decision making and his rapport with you, then there should be no reason that you need to seek the care of a specialist at this point in time. Should you and your physician struggle with obtaining tight control of blood sugars, or should other complications of diabetes develop that make management more complicated, then referral to an endocrinologist might be a good idea at that time.
Original posting 22 Jul 2002
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