Endocrinologist? Were you referred

[HSSS]

Now I don’t feel any burning desire to be referred for my diabetes but I’m curious. Some seem to have been referred on very borderline hb1ac or fasting scores. Others not at all despite high scores. Now I totally see the need if type 1 or complicated or particularly high but is there any consistency?

 

[Guzzler]

I was diagnosed with a 98. Since then the only people I've seen are box standard practice nurses. No DSN, no Endo and no doctor.

 

[Bluetit1802]

My HbA1c was a measly 53. I was diagnosed after a routine health check by a nurse, and a nurse is all I have seen in the 5 years since diagnosis. Not even a GP. I am not complaining. I love my nurse, and in general they know much more than the GPs do. I was under the impression that diabetes clinics at a hospital are for T1s and T2s that have specific difficult problems.

 

[Deleted member 308541]

No Endo, or Dsn either, I have seen a private CDE who bulk bills that has a clinic at my GP's practise twice in two years.

My GP is doing a great job looking after my T2.

 

[DCUKMod]

Now I don’t feel any burning desire to be referred for my diabetes but I’m curious. Some seem to have been referred on very borderline hb1ac or fasting scores. Others not at all despite high scores. Now I totally see the need if type 1 or complicated or particularly high but is there any consistency?

HSSS - these days, few T2s are referred solely for T2, but may be where there is another condition potentially impacting on matters, or where there is uncertainty of type.

A few years ago, in my locale, all diabetes patients were referred to the Endo visiting the cottage hospital weekly, and their care adopted by him. This is no longer so.

 

[ickihun]

I see the Endo until Bariatric bypass stablizes my bgs with far less insulin. My GP has been paying for my insulin and I'm an expensive patient. But hopefully not for much longer.

I have other autoimmune conditions so I was referred for a fresh look and because tablets stopped keeping me safe. I needed insulin.

Ive not heard of GPs starting insulin with a type2 without an endocrologists say so.

 

[Guzzler]

I see the Endo until Bariatric bypass stablizes my bgs with far less insulin. My GP has been paying for my insulin and I'm an expensive patient. But hopefully not for much longer.

I have other autoimmune conditions so I was referred for a fresh look and because tablets stopped keeping me safe. I needed insulin.

Ive not heard of GPs starting insulin with a type2 without an endocrologists say so.

Your GP pays for your insulin? Are you quite sure that it is not the NHS?

 

[Tophat1900]

My GP lacks knowledge in diabetes and in particular, cystic fibrosis related diabetes (CFRD). So, I got a referral to see an endo, the endo has a lot of experience with CF having worked a lot in London with CF kids at clinics. He's been great and something I needed. My gp is good too, just not so much with the CFRD... he's extremely helpfull. I actually asked for a referral and just happened to get a lucky break by getting the endo I now have.

I'm not sure about consistency, but I think being referred to an endo has it's pros and cons and it all depends on if you get a good endo or not.

 

[ickihun]

My GP lacks knowledge in diabetes and in particular, cystic fibrosis related diabetes (CFRD). So, I got a referral to see an endo, the endo has a lot of experience with CF having worked a lot in London with CF kids at clinics. He's been great and something I needed. My gp is good too, just not so much with the CFRD... he's extremely helpfull. I actually asked for a referral and just happened to get a lucky break by getting the endo I now have.

I'm not sure about consistency, but I think being referred to an endo has it's pros and cons and it all depends on if you get a good endo or not.

I've had 5 different ones but due to 2 pregnancies in different areas and once again now for insulin management.
I'm so lucky. I haven't had a bad one. They have been hugely helpful and worked with me. Very specific and detailed care.
Of course my regular endo has been more familiar than those covering pregnancy and thyroid issues. Those have been more concerned with tighter control for my healthy babies.

 

[ickihun]

Your GP pays for your insulin? Are you quite sure that it is not the NHS?

Luckily if it was true he could afford it. He's a hugely involved GP, in our area so his wage gets premiums galore. Mind u he's always working and a family man. Obviously something has to be compromised.
I now try to use his staff more than seeing him.
I am thinking of using pharmacist more.... however only the GP can ultimately prescribe something or treat a close emergency. Which is normally all I go to a Dr's practice anyway.
We have a lovely hugely experienced healthcare assistant who knows quite alot. Especially women's issues.

I feel very very fortunate.

I'm looking forward to not being so close or under their care as often though. I can touch it, it's that close.
Endo assured my discharge was imminent.

 

[HSSS]

HSSS - these days, few T2s are referred solely for T2, but may be where there is another condition potentially impacting on matters, or where there is uncertainty of type.

A few years ago, in my locale, all diabetes patients were referred to the Endo visiting the cottage hospital weekly, and their care adopted by him. This is no longer so.

I assumed that and as I say have no requirement to see one but I’d been reading a few posts where apparently lowish and straightforwardish t2 seem to have been referred. Market research you might call the question just to see if there’s consistency

 

[DCUKMod]

I assumed that and as I say have no requirement to see one but I’d been reading a few posts where apparently lowish and straightforwardish t2 seem to have been referred. Market research you might call the question just to see if there’s consistency

Of course, it's worth remembering a referral could be on a private basis. I'm not suggesting the all all, but just worth bearing in mind.

 

[Flora123]

Now I don’t feel any burning desire to be referred for my diabetes but I’m curious. Some seem to have been referred on very borderline hb1ac or fasting scores. Others not at all despite high scores. Now I totally see the need if type 1 or complicated or particularly high but is there any consistency?

I was referred to one. Hba1c of 112 I think but because I was slim the doc was confused!

 

[Brunneria]

Hi @HSSS

I see an endo, but not for my glucose dysfunction, even though the reason I go (prolactinoma) has a knock on impact on quite a lot of things, including blood glucose.

I’ve raised the subject of my RH/T2 glucose dysregulation with him once, with a view to requesting metformin as medication for polycystic ovary syndrome, and while he was very polite and engaged, he made it perfectly clear that unless i was referred to him by my doc for those conditions, he would not deal with them, preferring to focus on the thing that i had been referred for - the prolactinoma.

Rather frustrating, but i can see his point. Even docs usually have a ‘one appt/condition’ policy. If every T2 was referred then the clinics would never cope.

On the other hand, it would have been marvellous to meet a consultant who embraced the whole person, rather than taking a tunnel vision approach, especially when my hormones are so wacky that it is hard to find anything that they don’t screw up in some way (a tumour in the pituitry gland, which is known as ‘the master gland’ and then i mysteriously develop another tumour in the adrenals, plus PCOS, RH and glucose dysregulation). Gosh, do you think their might be connections between them...?

 

[Lamont D]

I'm not diabetic, but was misdiagnosed as T2 in 2009!
Before that about fifteen years ago, I was referred to a specialist, because my fatty liver was a concern for my GP at that time, The specialist believed that it was alcohol and my lifestyle! But as was quite often in my history health wise, they didn't believe that I was eating healthy and by then, I had stopped drinking because I couldn't do it no more! He just didn't believe me and dismissed me back to my GP!
He did no tests, except bloods, which clearly didn't show what was going on.
It was only when I had a hypo before my then GP in 2013, that I was referred again because my GP didn't have the training to actually know why I was going hypo as a T2, not being on the types of meds that cause it and believing that something else was going on. If not for that referral to my now specialist endocrinologist, and if I had another similar endo that I had seen a few years ago. I don't believe I would be around now! My new endocrinologist saved my life. He recognised the symptoms even though similar to T2, and did the diagnostic tests necessary. I was lucky!

I would definitely recommend that you get a referral, if your GP is struggling to understand, why you are not responding to treatment or diet! There are plenty of misdiagnosed patients out there, who while classed as type two that may have another metabolic condition.

 

[HSSS]

Hi @HSSS

I see an endo, but not for my glucose dysfunction, even though the reason I go (prolactinoma) has a knock on impact on quite a lot of things, including blood glucose.

I’ve raised the subject of my RH/T2 glucose dysregulation with him once, with a view to requesting metformin as medication for polycystic ovary syndrome, and while he was very polite and engaged, he made it perfectly clear that unless i was referred to him by my doc for those conditions, he would not deal with them, preferring to focus on the thing that i had been referred for - the prolactinoma.

Rather frustrating, but i can see his point. Even docs usually have a ‘one appt/condition’ policy. If every T2 was referred then the clinics would never cope.

On the other hand, it would have been marvellous to meet a consultant who embraced the whole person, rather than taking a tunnel vision approach, especially when my hormones are so wacky that it is hard to find anything that they don’t screw up in some way (a tumour in the pituitry gland, which is known as ‘the master gland’ and then i mysteriously develop another tumour in the adrenals, plus PCOS, RH and glucose dysregulation). Gosh, do you think their might be connections between them...?

One appointment for one condition is such short sighted view and potentially poor practice. It is expecting the patient to know what’s relevant to that one condition in their description of symptoms and disregarding knock on effects/causes of illness. I’m sure many things have been missed, misdiagnosed or inappropriately treated as a result