Dr. Einhorn shares if diabetic women should see a specialist or their general practitioners.
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 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.
About Dr. Einhorn:
Dr. Daniel Einhorn received his undergraduate degree from Yale University, his medical degree from Tufts University School of Medicine, and his internship, residency and fellowship at Harvard Medical School. He served on the faculty of Harvard until coming to San Diego in 1984, and has since been a clinical endocrinologist with Diabetes and Endocrine Associates, Associate Clinical Professor of Medicine (Voluntary) at University of California, San Diego, and, until 2000, the Medical Director of the Diabetes Treatment and Research Center at Sharp Healthcare. He is the Medical Director of the Scripps Whittier Institute Diabetes Program. Dr. Einhorn has held many leadership positions with the Board of the American Association of Clinical Endocrinologists, the American Medical Association's Diabetes Advisory Council and The Endocrine Society. He Chaired the American College of Endocrinology Task Force on the Insulin Resistance Syndrome and the Conference on the Insulin Resistance Syndrome. He has served on the American Diabetes Association (ADA) Managed Care Initiative and on the regional ADA and Juvenile Diabetes Foundation, and as Chair of the Diabetes and Pregnancy Program of San Diego and Imperial Counties. He is a fellow of the American College of Physicians and the American College of Endocrinology. His research and publications cover diabetes prevention and reversal, recognition and treatment of diabetic complications, new technologies, new pharmaceuticals, combination therapies, and clinical decision-making.
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