(MUSIC) As an endocrinologist,

I look after a range of conditions,

and these include patients with diabetes.

Well,

the endocrine,

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

in

the pancreas.

So,

endocrinologists have traditionally

cared

for people with diabetes.

We've done the research in diabetes.

We

monitor people with diabetes,

and we particularly monitor and manage them

to

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

Well,

in terms of diabetes,

when a patient is referred to us,

I think we're looking

for

several aspects.

First of all,

we want to gauge their understanding of diabetes.

Often,

they may have newly-diagnosed diabetes,

and they really need

to

be taken through

what

diabetes means,

what

they need to do to self-manage diabetes,

what medications they may need,

what

health professionals they may need to see,

and

also

to develop an understanding of how to prevent complications.

On the other hand,

if someone's had diabetes for a little while,

let's say a number of years,

and they are on medications,

they aren't doing particularly well,

then

we'll assess their overall metabolic control,

assess their diet,

their physical activity,

work

out what medications they should be on,

work out what complications we should

be

screening for.

And if there are complications present,

then,

dealing

with

these

hopefully

fairly

quickly.

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

dental problems which need to be looked for as well,

so we try to give a

holistic approach to a patient.

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

I think the specialists have an additional,

I guess,

expertise

at dealing with those with type 1 diabetes where,

management

and assessment can be very tricky.

There

are algorithms which one can use for type 2 diabetes,

but with type 1,

I think it takes a,

a,

a,

a specific,

I guess,

set of skills.

So, what does an endocrinologist bring to,

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

Well,

first of all,

I guess we have the expertise with the team approach.

I work

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

and I think that one has to understand that the

management of diabetes does not solely consist of drug treatment.

It

can be very complicated

with

lifestyle management,

particular

diets may need to be prescribed

a particular exercise regimen may need to be prescribed.

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

all

with

potential

side effects and some

with

particular benefits.

It can be a very harrowing and complicated

area for

the

general practitioner,

and that's,

again,

because it's our area of study and research,

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

And there're several combinations of medications which are

harmful

and

shouldn't

be used as well,

and can become very confusing for

the

the

particular

doctor.

So, that's where specialist comes in,

and of course looking after or looking for

complications again,

such as depression and sleep apnea and

looking after their dental work,

etc.,

it can be easy in a specialist setting sometimes,

particularly if the patient's very ill.

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

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

and

to

therefore

ask

on

the day rather than

wait till the next time.

I

think patients have to realize and understand that we,

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

to

look

after.

It can,

it's more than prescribing drugs,

it can be highly distressing for a patient

to

develop diabetes.

So, we want to highlight the benefits of

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

We

like to highlight the benefits,

for example,

of blood testing when you need to,

not doing too much,

but not doing too little.

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

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

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

etc.

So,

if you like,

we

like to be seen as

one

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

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