Dr. Daniel Einhorn explains if a diabetic woman should see a specialist or her general practitioner.
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So the question, who should be taking care of someone with diabetes, is a complicated one. It depends on the type of diabetes. Since type 1 diabetes requires a very complex data management -- you have to do multiple injections of insulin, multiple blood glucose checking, multiple variations day-to-day -- it takes a team. So you really need to know you’ve got more than any one person watching out for you. You need to have a dietician and a certified diabetes educator and hopefully a physician very versed in dealing with type 1 diabetes and typically, that’s an endocrinologist. But there are non-endocrinologists who specialize in type 1, and some physicians who are not endocrinologists who are very adept at type 1, and some endocrinologists don’t work with type 1. So you can’t know exactly from just the title that someone has whether they’re really the one for you, but it's an intimate relationship with type 1 diabetes. You get to know your treating physician very, very well, and they get to know you and your family very, very well. So you better be confident that you have a good relationship. Type 2 diabetes is a very different animal, and there are many different degrees of severity. Many people with type 2 diabetes could be treated quite successfully with modest changes in lifestyle and one or two or more oral agents, and life is pretty straightforward. There are not enough endocrinologists in the United States to see everybody with type 2 diabetes who needs them. So, we spend a lot of our time educating internists, family practitioners, and cardiologists in various communities to have a degree of comfort in managing at least the more straightforward situation with type 2 diabetes. Now there are some people type 2 who are very complex situations who require injectible therapies or insulin, and the more complex the therapy, the more you want the diabetes team and known diabetes specialist to be the person working with you.
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