If you’re living with diabetes, you know the routine: check your sugars, mind your carbs, take your medication. It’s hard to keep up with a proper diet, meds, activity, and the fear of highs and lows, especially when life is busy. You might be wondering, “Is this as good as it gets?” or “What else can I even do?” This is where many people feel stuck. Your primary care doctor is fantastic for general health, but when diabetes becomes complex or difficult to manage, it’s time to call in the specialist, the endocrinologist.
Who is an endocrinologist?
Endocrinologists are physicians who complete training in internal medicine or pediatrics and then do extra fellowship training focused solely on hormone-related disorders, known as endocrine diseases. Since diabetes is a condition involving the hormone insulin, it is a central part of their expertise. They treat Type 1, Type 2, gestational diabetes, and less common forms such as LADA or MODY.
How an endocrinologist helps
An endocrinologist provides a comprehensive and highly personalized approach to diabetes care. Their expertise translates into practical, daily support in several key areas:
- Precise diagnosis: They confirm your diabetes type and look for related issues like thyroid disease, high cholesterol, or insulin resistance.
- Personalized targets: Together, you set goals for A1C, blood sugars, weight, blood pressure, and cholesterol.
- Medication strategy: They choose and adjust medicines to fit your body, schedule, and budget. This can include insulin, metformin, GLP‑1 receptor agonists, SGLT2 inhibitors, or others.
- Technology guidance: They help you select and use tools like continuous glucose monitors (CGMs), smart insulin pens, or insulin pumps and closed‑loop systems.
- Prevention of complications: Regular screening for eyes, kidneys, nerves, heart, and feet, plus vaccines and referrals when needed.
- Education and coaching: You’ll often meet a diabetes educator and dietitian for meal planning, carb counting, sick‑day rules, and exercise tips.
- Care coordination: They work with your primary care doctor, eye doctor, cardiologist, or OB‑GYN (for pregnancy) to keep everyone on the same page.
What to Expect in a Typical Treatment Plan
At the first visit, an endocrinologist will review your health history, check recent labs, and look at your blood sugar patterns. They may order additional tests to confirm your type of diabetes or check for related conditions.
For Type 1 diabetes:
- Insulin treatment is the main therapy, usually with one dose that works all day and additional doses at mealtimes.
- CGMs and pumps are common, and many patients now use automated insulin delivery systems for tighter control.
For Type 2 diabetes:
- Lifestyle strategies, such as meal planning, physical activity, and weight management, are always part of the plan.
- First-line medication is often metformin, but endocrinologists add newer drugs such as GLP-1 receptor agonists (help with weight and blood sugar) or SGLT2 inhibitors (protect the heart and kidneys).
- Insulin may be introduced if blood sugars remain high or if other medications don’t work well enough.
Pregnancy and gestational diabetes:
- Endocrinologists work closely with OB-GYNs to monitor both mother and baby.
- Plans often include dietary changes, frequent glucose checks, and safe medications (sometimes insulin) during pregnancy.
Visit every 1–3 months at first and then every 3–6 months once stable. A1C is checked regularly, along with yearly eye exams, kidney tests, and foot checks.
When Should You Consider Seeing an Endocrinologist?
Not every person with diabetes needs to see a specialist right away, but there are certain situations where the expertise of an endocrinologist can make a big difference. If your current treatment isn’t working as well as it should, or your condition is becoming more complex, these are the times when specialist care is worth considering.
- Persistent high A1C: If your A1C remains elevated despite taking medications and making lifestyle changes, an endocrinologist can help adjust your plan and explore more advanced options.
- Frequent lows or unpredictable swings: Wide blood sugar fluctuations or repeated episodes of hypoglycemia can be dangerous. Endocrinologists are trained to fine-tune insulin and other medications to stabilize these patterns.
- Starting or struggling with technology: Whether you’re new to insulin therapy, a continuous glucose monitor (CGM), or an insulin pump, a specialist can guide you through setup, troubleshooting, and adjustments.
- Diabetes in pregnancy: Managing blood sugars during pregnancy (or while planning for one) requires tighter targets. Endocrinologists coordinate closely with OB-GYNs to protect both mother and baby.
- Complications or added conditions: If you’re facing issues with your kidneys, eyes, nerves, feet, or have other hormone-related disorders, an endocrinologist helps connect the dots and manage multiple health concerns at once.
- Unclear diagnosis: When the type of diabetes isn’t specific, such as in younger patients or those who may have late-onset Type 1, endocrinologists order specialized tests to clarify the diagnosis and select the right treatment path.
Final Word
Endocrinologists make diabetes management more manageable by combining individualized care, medical expertise, and new technology. Living with diabetes isn’t easy, but working with an endocrinologist means tackling challenges together, getting support that fits life’s realities, and staying ahead of complications, making day-to-day life safer, healthier, and more confident.
Find Your Expert in Diabetes Care at Hilltop Endo
If you’re looking for trusted, specialized care for diabetes, thyroid issues, or other hormone-related conditions, turn to Dr. Kehinde Folawewo, MD, at Hilltop Internal Medicine and Endocrinology. As a double board-certified endocrinologist, Dr. Folawewo provides expert, personalized care for a wide range of hormonal and metabolic disorders, helping patients take control of their health with confidence. Schedule your appointment with Dr. Kehinde Folawewo at Hilltop Internal Medicine and Endocrinology today and start your journey toward better hormonal and metabolic wellness.
