Who to contact and which doctor treats diabetes? Approximately such questions are often asked by patients in whom close relatives have diabetes. And given how common this disease is and how many complications there are, they should be considered in detail. After studying this publication, each patient will understand what the disease is, what is the reason for its multiple complications and what place doctors of various profiles occupy in their treatment.
Which doctor treats diabetes? Most often, this is an endocrinologist - a specialist in the therapeutic profile with a narrow specialization. Among his patients, diabetes is the most common. They make up almost 70%. More rarely endocrinologists with diabetes are therapists, and even less so are neurologists, ophthalmologists, gynecologists, surgeons and cardiologists. It will be right to say that there is practically no specialist in whose daily work one does not have to meet with diabetes.
Diabetes Angiopathies
Diabetes mellitus is a systemic disease, the essence of which is hyperglycemia. It develops due to insulin deficiency or acquired insulin resistance of cells. Since the lesion occurs in all vessels and cells, the disease is accompanied by systemic manifestations. Among them, microangiopathy and macroangiopathy, a special type of damage to the arteries of the body, causing ischemic manifestations in all tissues.
In the smallest vessels, a lesion of the type of multiple aneurysms in combination with hyalinosis is observed. In large arteries, starting from muscle-elastic, it has atherosclerotic narrowing with the appearance of turbulent blood flows (vortices). In the first case, all tissues suffer at a great distance from the heart, which ensures a violation of cellular nutrition. And in the case of damage to large arteries, heart attack and ischemic chronic diseases of the organ supplying them with blood develop.
The scale of angiopathy
Small arteries are present in all organs, and their hyalinosis affects blood supply and cellular nutrition. Visually assess the damage to small arteries by examining the vessels of the retina. Damage to their walls with tears of the smallest aneurysms and areas of hemorrhage are also present in other organs.
This provides specific damage to organs and tissues, for example, the kidneys, nervous system and brain, heart, skin, muscles. This also determines which doctor to contact for diabetes, because in this list there are pathologies of almost all specialists in the therapeutic and surgical profile. She touches the areas of professional competence of a general surgeon and podotherapist, cardiologist, neurologist, ophthalmologist, dermatologist, therapist and endocrinologist.
Hyperglycemia
It is the endocrinologist who will be responsible for the immediate treatment, who must choose such a scheme of hypoglycemic agents that would normalize the level of fasting glucose and control it during the day. This is necessary in order to prevent the acceleration of the development of vascular damage due to metabolic syndrome and diabetes. It is necessary to determine which doctor treats diabetes in a particular patient based on existing complications. They should be considered separately in each section.
Nephrological Profile of Diabetes
Kidney damage and the development of chronic renal failure requires treatment by a nephrologist. The initial chronic kidney disease, in which creatinine clearance is not reduced, but urine microalbuminuria has already appeared, requires constant monitoring by a physician. It is important to understand that a specialist is not required to monitor the patient’s health status instead. If the patient really cares about his own health, he must follow the schedule of the follow-up, knowing the dates of his scheduled examinations.
This measure is required for the dynamic tracking of blood and urine tests, which will make it possible to judge the degree of controllability of the disease. This recommendation will be given to patients with diabetes mellitus by every specialist whom the patient will visit. Moreover, the main goal of the follow-up is the early detection of the progression and transformation of chronic kidney disease into terminal renal failure. It is easy to track if the patient really will come to receptions and follow the recommendations of a specialist.
Ophthalmic profile of diabetes
An ophthalmologist is often the specialist who first sees visual signs of the development of the disease. During the examination (ophthalmoscopy or biomicroscopy), the presence of a vascular lesion will be determined. It is the basis of visual impairment, because with the appearance of pathologies of small vessels, the intensity of blood supply to the retina significantly decreases. Its receptor cells die, which reduces visual acuity. Moreover, the presence of vascular lesions in diabetes leads to a deterioration in the healing of tissue damage. This leads to the fact that such patients are often refused even ophthalmic surgery due to the high risk of complications.
Surgical Diabetes Profile
The most unpleasant component of diabetes is microangiopathy, which mediates the deterioration of tissue healing in case of damage. But eating disorders due to a significant narrowing of the vessels that bring arterial blood can cause diseases without injury. An example is foot damage in diabetes. Together with atherosclerosis of large arteries, angiopathy of the vessels of the foot can cause gangrene. Her surgical treatment in conditions of low regenerative potential requires long-term rehabilitation. Here, there is a high risk of wound infection, which is also typical for patients with diabetes.
Endocrinological and therapeutic profile of diabetes
Which doctor defines diabetes and which one treats it can vary significantly. It is not uncommon for an ophthalmologist to suspect diabetes during a routine examination of the fundus. But more often than others, the therapist will hear the first complaints from patients with diabetes or impaired glucose tolerance. Also, due to the fact that the patient must be tested before a routine examination, the frequency of early detection of diabetes has increased. This is available due to the presence of fasting glycemia in the spectrum of mandatory studies.
No matter where a particular patient treats diabetes, he will always be in contact with both the endocrinologist and therapist. The latter is engaged in the correction of taking hypoglycemic tablets. The injection schedule (monoinsulin and protamine-insulin) is developed only by an endocrinologist. Their joint work in the endocrinology center of St. Petersburg will delay the aggravation of vascular damage by maintaining stable levels of glycemia.
Patient flows
The clinical form of the disease will determine which doctor treats diabetes in a particular patient. Type 1 diabetes mellitus associated with absolute insulin deficiency requires follow-up and treatment by an endocrinologist. This specialist is the main one for a patient with this form of the disease, while doctors of other specialties will be involved when signs of complications appear.
In the case of type 2 diabetes mellitus , the endocrinologist, who treats and eliminates hyperglycemia, will prescribe hypoglycemic agents and monitor the adequacy of therapy. That is, he will monitor how well the drug therapy regimen is selected. If taking tablets is not enough, then a full or partial transfer to insulin therapy will be carried out by a diabetes doctor. What is the name of the drug for treatment and how to use it, the doctor will also explain to his patient.
Endocrinology in St. Petersburg
In St. Petersburg, the treatment of endocrinological diseases, including diabetes, is carried out by city hospitals and specialized centers. They have established treatment according to the territorial principle and in the direction of the outpatient unit. Patients have access to self-paid treatment at specialized endocrinological centers of St. Petersburg:
- North-West Endocrinology Center on the street. Savushkina, 124, building 1. or on Kronkverksky Avenue, 31.
- Regional Endocrinology Center N.I. Pirogov on the embankment of the Fontanka River, 154.
- National Medical Research Center. V.A. Almazova on Akkuratova, 2.
- Endocrinology Center of the Elizabethan Hospital on the street. Vavilov, 4.
- Pediatric endocrinology is available at the Children's Clinical Hospital No. 19 named after K.A.
In endocrinology centers of St. Petersburg, diabetes treatment is aimed at increasing life expectancy and improving its comfort for the patient. Experts are convinced that in addition to high-quality pharmacological regimens for successful therapy, patients should be taught the rules of nutrition and discipline in food. Diabetes mellitus is a disease that is very dependent on nutrition. And when it changes, the treatment regimen should also change.
Unfortunately, such a maneuver is not possible if the patient changes daily eating habits or violates nutritional rules. Any endocrinologist who treats diabetes and its complications will say that a patient with such a disease may not deny himself physical activity, but he must strictly comply with dietary recommendations. Therefore, when visiting a doctor, you should ask for recommendations on the organization of your diet.
Nutrition Consultation
A reasonable decision would be to visit a dietitian. This will allow you to develop sample menu items, and such recommendations are more detailed, formalized and limited to clear boundaries. Therefore, it will be easier to execute them on the list, which will ultimately improve the quality of treatment. An endocrinologist or therapist can also give advice on diet, however, due to the lack of preparation in the formation of diets, they will be less effective due to their ambiguous understanding by the patient. It should be remembered that diabetes requires discipline, and therefore its nutrition should be organized and constantly strictly controlled. The selection of approximate menu schemes should be individual, which will help the nutritionist.