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    How can an Endocrinologist help a Diabetic?
    salesjag105 posted:
    I am a type-2 diabetic struggling to get it under control.

    I exercise, eat fairly well, and take metformin, glipizide, and 24-hour insulin. Still, my numbers are erratic.

    A friend suggested that I find a good Endocrinologist.

    How might seeing an endocrinologist help me?
    DoloresTeresa responded:
    If you are a type two and don't switch to a very low fat, no oils, no processed foods, no dairy, miniscule amounts of animal protein, plant based diet of fruits, vegetables, whole grains and beans the endocrinologist will help you out of lots of money and spend time adjusting your meds.

    If you eat right and exercise you, like many others, can either greatly reduce or eliminate your meds. Joel Fuhrman and John McDougall are two doctors who can be found on the internet who prescribe diets that have reversed diabetes.

    DavidHueben responded:

    Endocrinologists are specifically trained to deal with diseases of the endocrine system including thyroid conditions, diabetes, metabolic syndrome, etc.

    You said your glucose levels are "erratic". Could you be more specific? What was your last A1C level? What are your average fasting and two hour post-prandial glucose levels? Are you overweight? What does eating "fairly well" mean?

    We sleep soundly in our beds because rough men stand ready in the night to visit violence on those who would do us harm. - Winston S. Churchill
    Anon_74671 responded:
    In my experience, all my endo does is write prescriptions (which my family doctor could do).

    I find I am better served by my CDE (certified diabetes educator) and my dietician. They help me regulate my insulin, spot trends in my sugar levels, make food choices and count carbs

    Diabetics need to see more than a doctor, we need a whole diabetes management team.
    auriga1 responded:
    Since you are struggling to get your diabetes under control, it may be a good idea to look for another doctor if you can.

    I was diagnosed with diabetes when hospitalized for something else. My doctors recommended an endocrinologist to me. As David mentioned, they specialize in endocrine disorders, diabetes being one of them. The pancreas is part of the endocrine system, the gland that secretes insulin to help regulate your blood sugar.

    I don't know about other diabetics, but my endo is part of a diabetic team; doctor, CDE and dietician. I was diagnosed as an uncontrolled diabetic with an A1C of 13.2. They all worked with me to bring that A1C down. I use two insulins, one being the basal (24 hr.) and the other a rapid-acting insulin to be used with meals and/or to bring my BS down where it should be. I have managed to bring my A1C down to 6.0 with the right amount of insulin, diet and exercise.

    Would it hurt to get a second opinion? If you are doing everything you can with our diet and exercise, it might be a good idea to see someone else.
    nutrijoy responded:
    It sounds like what you really need is a lot more self-education to determine how foods (types as well as portion sizes) affect you personally. Then by modifying your consumption of those foods, you will be able to achieve more consistent results.

    From a personal standpoint, my A1c is currently 5.2 (drop from 5.3 three months ago). I was testing my BG levels up to TEN times a day initially and maintained a food log to determine how various foods affected me individually. By gradually adjusting my diet, I have been able to maintain reasonably good control of both my post prandial and fasting BG levels. While the methodology is relatively straight-forward, the path can be pretty bumpy and a good diabetes educator and endo can perhaps provide you with the guidance needed.

    Alternatively, you can read lots and lots and lots of books and articles on the topic to determine what works best for YOU because the advice and suggestions in the books can often appear to be contradictory.
    MSUphysicsFRIB replied to DoloresTeresa's response:
    I was diagnosed with prediabetes and PCOS (a disorder caused by insulin resistance and high insulin levels) after following a vegan diet. Switching to a hunter/gatherer diet has helped me immensely. Everyone's body is different. If someone's diet is a train wreck and he/she is very overweight, then changing to any diet that results in weight loss and reduces the amount of junk food might help. However, for normal-weight diabetics with a generally healthy diet, a low-glycemic hunter/gatherer diet is the next step up, and might be exactly what is needed to improve insulin sensitivity and glucose control.
    mhall6252 replied to MSUphysicsFRIB's response:
    I agree with you on the hunter/gatherer sort of diet. It has worked for me, although I still take metformin to keep glucose levels in good control.

    An endocrinologist should look at the entire endocrine system, not just the glucose numbers. There could be other things working against a person (thyroid, other auto-immune diseases) that should be investigated. Yes, a good thorough PCP MIGHT be thorough enough and knowledgeable enough to turn over every rock. Sometimes, though, a specialist is warranted.

    betaquartz replied to mhall6252's response:
    We have gone through this vegetarian/omnivore discussion so often here that to us that have been around it is redundant. That said I will add that

    Education seems to do a lot to help a new or struggling diabetic. Educate yourself about the different approaches to T2 reversal, and the lifestyle commitment you are willing to make. If this happens to include an endocrinologist or an educator or both so be it. However, it is easier to deal with them if you have some base knowledge to ask questions and digest answers.Test when you need to, and learn from your testing. What kicks you up, what stabilizes you?

    Diets that are high in vegetable intake and follow glycemic index and load seem to be working for many of the people here. At the same time even though many of the people here do not admit to low carb diets, they do seem to be following low Hi-glycemic index foods. This usually means cutting way back on grain, and removing white flours and sugars. I won't presume for every one but it works for many, including myself. Fats are something that can be good or bad. In particular keep your meats lean, and add more fish(variety) include the oils of nuts, avocado, and other vegetable oils, Work on 3 meals and 2 snacks, and adjust for you needs.

    Exercise is a big part of the lifestyle formula. After all, the research shows that the waist line indicator raises the chances of getting T2. Logically then it would seem that removing as much as that waistline bulk would improve your chances with T2. Core exercises work well here, along with aerobic exercises that will help the lungs and heart and burn fats.

    Above all don't get discouraged, and keep plugging. Constant little steps add up.
    salesjag105 responded:
    Thank you, everyone who has responded to my question. Thank you for the input and suggestions. I'd like to share the rest of the story.

    My life has improved dramatically in the last 8 days. Mainly because of a commitment I made 8 days ago to begin to really eat right, and to get off 24-hour insulin (Lantus).

    I went cold-turkey on the Insulin, and 3 days ago, I almost gave in to the urge to refill my Lantus prescription. But 3 days ago, my blood-sugar numbers started to come down.

    My diet for the past 8 days has consisted of Tilapia fillets, tuna fish, raw-spinach salads, egg whites, and zero-calorie carbonated soda pop for my sweet tooth. So far, so good.

    I continue to work out early every morning at the gym.

    Eight days might not seem like a lot to many of you who've been doing it for a lifetime, but It's a huge door opener for me. I am energized.

    I still might eventually see and Endocrinologist, but for now, I'm going to schedule an appointment with my primary care physician, and bring him up to date.

    Your generous words of advice have been much-needed words of encouragement to me. So I thank you all, once again.
    betaquartz replied to salesjag105's response:
    This is good news, and you should feel proud. I am especially happy that you are seeing your primary care physician to keep in the loop. Pay attention to his advice, and make certain you have not jumped too far. Keep us informed of your progress.
    JimL1947 responded:
    Exercise 15 minutes a day, maybe even twice a day.Your A1C should be between 7 - 8. Some professionals say below 7.
    However trying to control to much can bring on lower dangerous blood sugar levels. Adding a Byetta shot before breakfast & before dinner can really help instead of metformin & Glipizide.
    If you can keep sugar levels at 180 or below then your A1C will be 7. Please keep this in mind when you see Endocrinologist.
    Of course if over weight lose 10% of your boby weigt is a good start to control. Hope this helps
    V/r Jim
    Anon_1092 replied to JimL1947's response:

    I appreciate your thoughts but disagree with you about A1c being 7-8 and glucose levels under 180. The American Diabetes associaiton calls for A1c under 7 and glucose under 180 2 hours after eating.

    That said everyone needs to work with their medical team to determine what their specific goals are and how they will achieve them. Of course things like age, activity level and other medical conditions need to be taken into account.
    DavidHueben replied to JimL1947's response:

    I would have to agree with Anon that an A1C between 7% and 8% is too high. Here are a couple of points to consider:

    1. As stated, the ADA recommends an A1C below 7.0%.

    2. The AACE has even more restrictive clinical practice standards. They recommend an A1C below 6.5%. In fact, the AACE defines a diagnosis of diabetes as any A1C of 6.5% or greater.

    3. My physician wants me to keep my A1C below 6.0% and my fasting blood glucose below 100 on a daily basis. My last A1C was 5.2%. If my A1C was above 7.0%, he would personally drive me to a gym!!!

    Of course, these blood test results targets should be mutually agreed to between the patient and doctor.

    We sleep soundly in our beds because rough men stand ready in the night to visit violence on those who would do us harm. - Winston S. Churchill
    Lh60453 responded:
    An endocrinologist is a specialist dealing with the immune system and can provide you with specific information after testing on why your diabetes is not controlled. You need to maintain a journal (use a notebook) of what you eat daily because this is why you are having problems. Portion control is another issue. You ar prbably eating too much of the wrong foods. Use the internet and learn about the "Glycemic Index." It talks about the higher glucose response to some foods, like potatoes , breads, white rice. Learn about the right foods to eat and see a dietitian.

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