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(MUSIC) As an endocrinologist,

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I look after a range of conditions,

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and these include patients with diabetes.

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Well,

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the endocrine,

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a part of that is that insulin is made by an endocrine gland

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in

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the pancreas.

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So,

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endocrinologists have traditionally

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cared

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for people with diabetes.

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We've done the research in diabetes.

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We

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monitor people with diabetes,

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and we particularly monitor and manage them

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to

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ensure no complications or to ensure that their complication risk is minimized.

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Well,

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in terms of diabetes,

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when a patient is referred to us,

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I think we're looking 

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for

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several aspects.

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First of all,

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we want to gauge their understanding of diabetes.

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Often,

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they may have newly-diagnosed diabetes,

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and they really need

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to

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be taken through

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what

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diabetes means,

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what

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they need to do to self-manage diabetes,

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what medications they may need,

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what

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health professionals they may need to see,

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and

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also

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to develop an understanding of how to prevent complications.

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On the other hand,

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if someone's had diabetes for a little while,

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let's say a number of years,

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and they are on medications,

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they aren't doing particularly well,

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then

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we'll assess their overall metabolic control,

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assess their diet,

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their physical activity,

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work

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out what medications they should be on,

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work out what complications we should

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be

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screening for.

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And if there are complications present,

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then,

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dealing 

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with

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these

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hopefully

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fairly

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quickly.

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There are also other conditions such as depression and sleep apnea,

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dental problems which need to be looked for as well,

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so we try to give a

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holistic approach to a patient.

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I think the GP's do a great job with looking after particularly type 2 diabetes.

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I think the specialists have an additional,

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I guess,

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expertise

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at dealing with those with type 1 diabetes where,

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management

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and assessment can be very tricky.

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There

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are algorithms which one can use for type 2 diabetes,

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but with type 1,

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I think it takes a,

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a,

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a,

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a specific,

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I guess,

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set of skills.

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So, what does an endocrinologist bring to,

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I guess the diabetes patient which the GP may not have?

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Well,

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first of all,

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I guess we have the expertise with the team approach.

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I work 

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with a team of diabetes educators and a dietician and an excise physiologist,

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and I think that one has to understand that the

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management of diabetes does not solely consist of drug treatment.

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It

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can be very complicated

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with

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lifestyle management,

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particular 

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diets may need to be prescribed

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a particular exercise regimen may need to be prescribed.

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There are so many medications now available for type 2 diabetes,

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all

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with

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potential

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side effects and some

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with

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particular benefits.

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It can be a very harrowing and complicated

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area for

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the

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general practitioner,

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and that's,

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again,

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because it's our area of study and research,

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that's what we are more used to dealing with.

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And there're several combinations of medications which are 

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harmful

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and

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shouldn't

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be used as well,

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and can become very confusing for

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the

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the

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particular

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doctor.

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So, that's where specialist comes in,

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and of course looking after or looking for

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complications again,

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such as depression and sleep apnea and

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looking after their dental work,

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etc.,

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it can be easy in a specialist setting sometimes,

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particularly if the patient's very ill.

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So, the patient has a whole range of questions and it's very useful

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I think for them to have a list of questions to ask us

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and

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to

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therefore

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ask

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on

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the day rather than

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wait till the next time.

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I

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think patients have to realize and understand that we,

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as endocrinologists do acknowledge that diabetes can be a very complex condition

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to

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look

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after.

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It can,

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it's more than prescribing drugs,

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it can be highly distressing for a patient

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to

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develop diabetes.

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So, we want to highlight the benefits of

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early treatment and management to prevent problems occurring in the future.

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We

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like to highlight the benefits,

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for example,

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of blood testing when you need to,

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not doing too much,

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but not doing too little.

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We like to highlight the benefits of seeing the GPs for regular

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checks and seeing the other specialists to ensure no eye disease,

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seeing a podiatrist to ensure that there's no foot disease,

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etc.

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So,

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if you like,

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we

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like to be seen as

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one

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of the key players in managing diabetes along with the GP,

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along with the diabetes educator and dietician if they're required as well. (MUSIC)