My doctor says I don’t need to see a specialist for my diabetes.How do I know if my doctor is right?

My doctor says I don’t need to see a specialist for my diabetes.How do I know if my doctor is right?

At the time of writing, there are estimated to be about 16 million adults in the United States who are aware that they have diabetes. There are, however, only about 4000 certified adult diabetes specialists in clinical practice and not all of these are in full-time practice. Some, perhaps one in four, do not see patients with diabetes at all. This translates to one diabetes specialist for every 5000 people with diabetes. Those who are interested in learning more about the shortage of diabetes specialists in the United States can visit http:// www.endo-society.org/advocacy/legislative/upload/ A-Stewart-US-Endo-Workforce-A-Supply-Demand- Mismatch.pdf.

The average diabetes specialist carries a clinic census of several hundred active patients, each of whom he or she sees from two to several times per year. From these statistics, it is clear that the vast majority of people with diabetes will not be able to consult a specialist. However, not all people with diabetes need specialist input, and those who do will usually not require it for the majority of the course of the disease, especially in the case of type 2 diabetes. Much of the education necessary to effectively manage diabetes, especially that centering on glucose monitoring and diet and nutrition, is accessible by referral directly from your family doctor. Given its frequency, many family doctors see a considerable number of patients with diabetes and are competent in its routine management. They also generally make effective judgments as to when specialist consultation is advisable.

Some of the circumstances in which consultation with a diabetes specialist is often advisable are shown in Table 13.