Joslin Answers Your Questions

Joslin Diabetes Center experts answer commonly asked questions about diabetes monitoring, treatment, self-care, meal planning, and more.
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Topic: General Concerns
Question: When should I see a diabetes specialist instead of my primary care physician? In addition to my physician?

Answer: The answer depends on several pieces of information that you have, or should have, available.

First, you should have the results of five key tests that determine your risk for future diabetes-related complications:
  1. A1C
  2. Blood pressure
  3. Lipids (LDL and HDL cholesterol, as well as triglycerides)
  4. Microalbumin
  5. Dilated eye exam

If the results of any of these are outside of your target, then you should ask your primary care physician for advice about improving them. If they remain out of range, that would be a reason for a referral to a specialist to see if you could find a successful approach to improving the specific result or results that are out of range.

What if your test results are all in a good range? First, congratulations! You have done a good job of reducing your risk.

However, there are still some other good reasons for a referral. For example, you may have satisfactory test results, but are having too much difficulty maintaining them. Perhaps an insulin pump, a continuous glucose monitor, the addition of a new medication, or an adjustment in your present regimen could provide you with some relief. If you are on insulin and are having too many low blood glucose episodes, seeing an endocrinologist and/or a diabetes educator could help you determine if you should change your insulin, food, or exercise regimen. Or, maybe you are doing well and are feeling fairly comfortable with your diabetes regimen, but are curious about new medicines, devices, or research. In addition, you may just want to touch base with a specialist to make sure that "all your bases are covered." These all are good reasons for a referral to a diabetes specialist.

The two most important points to keep in mind about your diabetes are that:
  • you need to feel reasonably comfortable with the ways in which you are fitting diabetes management into your life, and
  • you are confident that your test results are in a range that will protect you from future complications. If you aren't quite where you want to be, then seeking some additional advice is the right step to take.

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