Diabetic Doctor, endocrinologist and Telemedicine

Telemedicine for diabetes entails virtual doctor visits, remote glucose monitoring, and intervention. The doctor can prescribe diabetic medication and follow up with the patient very closely. Telemedicine for diabetes creates an alternative way of management instead of seeing traditional diabetic doctors.  Diabetes currently affects nearly 425 million people in the world, with Type-2 cases being the most prevalent. Diabetic doctors are far and in between.

Nearly 33% of the adult population in the US are pre-diabetic, while 10% are already living with a diagnosis. There are only 3000 clinical endocrinologist or diabetes doctors taking care of diabetic patients. A lack of proper guidance, care, and prevention can lead to worsening symptoms. Patients end up developing advanced stages of type 2 diabetes without proper care.

In most cases, people don’t realize that they have hyperglycemic symptoms until it’s too late.  Some others resort to harsh blood-sugar tablets. It’s important to keep in mind that diabetes is a multifactorial disease process with lifestyle affecting it. It is much more than just swallowing a tablet or taking an insulin shot.

It requires a particular lifestyle that comprises healthy life choices. This is something that your doctor might briefly touch upon. However, a healthy mindset and habits deserve a far greater mention than they’re given. A true diabetic doctor will have a team of professionals who can attack the disease from multiple aspects.

For this reason, the importance of a diabetic coach simply can’ be stressed enough. They assist you with holistic remedies and lifestyle changes that are monumental in lowering diabetic symptoms in the long-term. While a doctor may just be concerned about your prescription course, a diabetic coach deals with your hormonal, psychological, and physical issues altogether. To achieve the final goal diabetic doctor and diabetic coaches work together.

According to a study conducted by Patrick McGowan, Ph.D. from the University of Victoria, complying with a diabetic coach improved outcomes. Over the period of 6-12 months resulted there was a visible improvement in health outcomes. After a year of following up with a diabetes doctor, the patients’ self-efficacy had risen by 22% with most of them reporting positive diabetes empowerment.

They felt in control of the food they put in their bodies, thereby lowering down high and low blood sugar symptoms.  Their depression levels reportedly decreased by 24%. Medical compliance and communication with their physicians increased by 22%.


Understand the Role of a Diabetes Coach

Diabetes is one of the most common hormonal disorders worldwide. And, so a diabetic doctor is typically an endocrinologist who specializes in hormonal issues. They diagnose and treat diabetes on a daily basis. An endocrinologist is typically an internist-trained physician with 2 additional years of fellowship training.

Diabetes occurs as a result of an absolute or relative deficiency of insulin or insulin resistance. Type 1 diabetes is due to an absolute deficiency of insulin. On the other hand, type 2 diabetes occurs as a result of insulin resistance and, or relative insulin deficiency.

Many people even gain weight due to excessive calories. However, only a portion of overweight people actually develops diabetes later in their lives. This is essentially determined by genetics. Hence, family history plays a vital role in determining the occurrence of diabetes.

“Diabetes is not created equal and not all diabetes doctors are the same”

Diabetic doctors diagnose and differentiate types and forms of diabetes. This includes type 2 diabetes, type-1 diabetes, along with many other types not commonly known by the public. According to the CDC, 90 percent of people with diabetes in the United States have type 2. Only 5 percent of people have type 1. Another 5 percent had other types of diabetes.  A regular doctor may not be able to differentiate the type of diabetes correctly. Understanding the type of diabetes makes a big difference in selecting treatment options.

 

The Lesser-Known Types of Diabetes

How about the other 5 percent? We all know type 1 and type 2 diabetes. There is a type of diabetes that diabetic patients do not know about, MODY (Maturity onset diabetes of the young). It is totally different from diabetes type 1 or type 2. MODY happens due to a single gene mutation, whereas type 2 diabetes is a multi-genetic disorder. Another subgroup of patients may have type 1.5 diabetes in other words LADA. LADA stands for Latent autoimmune diabetes of adults.

If a parent has the disorder, any child of that parent has a 50 percent chance of inheriting the MODY disorder. There are many subtypes of MODY. Although some types can lead to severely high blood glucose, some types of MODY present with mildly high blood sugars.  Sometimes they do not require treatment at all. After a thorough assessment diabetic doctors can find out what type of diabetes you have any may not even need treatment if you have this type of diabetes.

Patients with MODY also do not develop complications of diabetes. Frequently, this type of MODY is misdiagnosed, and patients are put on lifelong treatments that would not be needed otherwise. Thankfully, MODY is a rare form of diabetes.

Only 2 percent of patients with diabetes have MODY. The rest 2-3 percent of patients with diabetes have type 1.5 or type 3 diabetes. This is sometimes referred to as LADA (Latent autoimmune diabetes in adults). LADA is a form of type 1 diabetes that occurs in adults.

It often has a slower course of onset than type 1 diabetes diagnosed in children. However, adults with LADA can be misdiagnosed with type 2 diabetes. These patients are not overweight and are typically diagnosed at a much younger age.

Most patients with LADA can be treated as type 2 diabetes. However, they eventually fail the treatment and become insulin-dependent. Their insulin requirements are far more aggressive than a typical diabetic patient. In severe cases, exercise and a healthy diet don’t help as much as it does for patients with type-1 and type-2.

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How a Diabetic Coach & Diabetic Doctor Leverages Technology

They are also up-to-date with the most recent developments in diabetes care and technology. A diabetes doctor can manage your insulin pump and continuous glucose monitor. Most of these units are becoming increasingly hi-tech and advanced as we speak. Only an endocrinologist can program and manage an insulin pump. We use state of the art application to help manage from your cell phone.

Patients using them typically report better quality of life compared to using insulin pens or syringes. This is because of insulin pumps:

  • Eliminate the need for injections
  • Deliver more insulin than shots
  • Improve Hemoglobin A1C
  • Allow greater flexibility with your meals
  • Prevents unpredictable, long-term side-effects of insulin

Hi-tech insulin pumps administer insulin very slowly at a programmed speed and provide only what the patient needs. We can adjust the rate hourly. Since the human body requires different amounts of basal insulin at different times of the day, this feature prevents over or under-administration of insulin. Insulin pumps are good for patients looking to obtain freedom from injections and record-keeping, but also motivated to control diabetes with timely insulin delivery.

Bolus Insulin

Another feature is that insulin pumps can calculate the required bolus of insulin. This is based on the patient-reported amount of carbohydrate content of the food. This allows precise insulin delivery, preventing the chances of very high or very low blood sugar after a bolus insulin delivery.

Continuous Glucose Monitoring for Diabetic Care

On the other hand, continuous glucose monitoring provides a 24-hour reading of tissue blood glucose levels. Numeric values obtained from a continuous glucose monitor can be slightly different than fingersticks. Because there is a difference between blood and tissue glucose levels. You can find this very well explained in our blogs. 

This becomes more apparent during rapidly rising or falling blood sugar levels. Yet, these devices are very useful to track and analyze blood sugar trends. Some of them will also alert you with an alarm before a high or low glucose occurs based on the blood sugar trends.

For example, if the glucose detected by the glucose monitoring device is 120 but is rapidly declining at the tissue level, the device will alert you to take action immediately. By preventing blood sugar from hitting below 70 mg/dl – the clinically recommended level – it adjusts the levels accordingly.

How can a Diabetes Coach help?

A diabetic coach in partnership with diabetes doctor can help you make adjustments in insulin. This also applies to any medication that can erratically increase insulin levels like glipizide, glyburide, or glimepiride. However, these  CGM devices can be very expensive without insurance coverage.

Therefore, your endocrinologist/diabetic doctor will order special testing and provide clinical documentation. this will help insurance companies to approve insulin pumps or continuous glucose monitoring. These devices will improve your diabetes care so much!

Most diabetic coaches recommend that patients who use insulin should wear a glucose monitoring device at all times.

 

What Sets an Endocrinologist/diabetes doctor apart?

An Endocrinologist/diabetic doctor will give you valuable advice as well as send in prescriptions for all the medications and medical devices such as insulin pumps or continuous glucose monitoring devices. They typically also work on your prior authorizations that can take a tremendous amount of time.

Most of the time, primary care doctors do not have the time or the resources to do prior authorizations for their patients. Diabetic doctors who are typically endocrinologists can make strong arguments to give the best possible care for the patients’ suffering from diabetes.

There are so many options to treat diabetes, so knowing the options for diabetic patients is extremely important. Diabetes is a burdensome disease affecting a person’s life in every aspect. As a result, making life easy by tweaking, adjusting, or introducing new treatments can make a big difference in a diabetic patient’s life.

Diabetic doctors are seeing patients with diabetes every day. Diabetes doctors have special training that takes years. More importantly, diabetes doctors have the necessary knowledge, tools, and experience. Even though they have extensive expertise under their belt, there are far too many diabetic patients as compared to endocrinologists. SugarMDs offer a telemedicine solution where you do not have to desperately search for a local endocrinologist.

Defining ‘Diabetes Control’

Typically, primary care doctors take the lead. Unfortunately, only 50 percent of all patients with diabetes are under control. What is more worrisome is that diabetes control is a very vague term. There are a variety of diabetes associations recommending different guidelines.

For example, the American Association of Clinical Endocrinologists recommends a goal A1c of 6.5.  The American Diabetes Association recommends 7 percent or below as the target A1c control. Most recently, The American College of Physicians recommended up to 8 percent out of frustration that primary care doctors could not achieve diabetes control goals. diabetes control check

 

 

Guidelines are not all the same for Diabetes glucose goals

There is a basis for the recommendations from these organizations. Every organization has its mission and priorities when they make recommendations. The American Association of Clinical Endocrinologists has the most strict guidelines.  Because they understand that diabetes complications can happen very early on and start from 6.5 percent A1c.  Every 1 percent A1c increase can increase the risk of complications by 30 percent.

In other words, an A1c goal of 8 percent puts you at 40 percent more risk for developing diabetes-related complications. Ideally, the A1c target should be as low as reasonably achievable. It is possible for patients to get their A1c below 6 percent with a targeted lifestyle adjustment, effective medications, or both.

Remote Diabetes Care

Recently, organizations started to make recommendations for remote diabetes monitoring and care.  It is not practical to see individual patients that frequently. As a result, telehealth is gaining popularity. Patients have shown a significant fondness in discussing their diabetic symptoms and solutions over the cell-phone. Unfortunately, this is a new technology, and only a few companies exist with limited services for these common conditions. www.sugarmds.com is the first in telemedicine for diabetes.

The Future of Telemedicine for Diabetics

Nowadays, there are few endocrinologists or online diabetes doctors in the entire nation who can manage diabetes remotely without the patient needing to go to their office. Needless to say, you will not have to spend time driving to the doctor’s office. No more waiting in crowded waiting rooms see the doctor and then another wait in the exam room for the doctor to show up.

Telemedicine is a healthcare practice that has been used by people since the 19th century. A recent study conducted in four European Countries observed a growing number of donors, funding approaches, and policy-makers who advocated remote healthcare.

Chronic disease management with Telehealth and online diabetes care

By assisting with remote monitoring for chronic diseases like diabetes, heart failure, and pulmonary diseases, patients felt more in control of their health. Using telemedicine, a diabetes doctor will be able to monitor your blood sugars as frequently as needed without the need to call or show up to the doctor’s office.

All you have to do is check your blood sugar either with a continuous glucose monitor (some of which does not even require finger stick measurements anymore) or use a typical meter and upload your results. The diabetes doctor will review the data.

The Future of Telemedicine for Diabetics

Nowadays, there are few endocrinologists or online diabetes doctors in the entire nation who can manage diabetes remotely without the patient needing to go to their office. Needless to say, you will not have to spend time driving to the doctor’s office. No more waiting in crowded waiting rooms see the doctor and then another wait in the exam room for the doctor to show up.

Telemedicine is a healthcare practice that has been used by people since the 19th century. A recent study conducted in four European Countries observed a growing number of donors, funding approaches, and policy-makers who advocated remote healthcare.

Chronic disease management with Telehealth and online diabetes care

By assisting with remote monitoring for chronic diseases like diabetes, heart failure, and pulmonary diseases, patients felt more in control of their health. Using telemedicine, a diabetes doctor will be able to monitor your blood sugars as frequently as needed without the need to call or show up to the doctor’s office.

All you have to do is check your blood sugar either with a continuous glucose monitor (some of which does not even require finger stick measurements anymore) or use a typical meter and upload your results. The diabetes doctor will review the data.

 

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Where to Look for best diabetic doctors providing telemedicine?

At SugarMDs, endocrinologists – “diabetes doctors” will provide you state of the art care from the convenience of your home. They will monitor you closely to achieve your goals, and help you live a long, happy life without complications of diabetes getting in the way!

 

Author: Ahmet Ergin, MD, FACE, CDCES, ECNU

About the author: Dr. Ergin operates a large diabetes practice mostly in West Palm Beach, FL, and yet can see diabetic patients across the entire state of Florida via a unique telehealth platform which also allows him and his team to track patient progress and be available at all times.

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