Who should I contact and which doctor treats diabetes? Approximately such questions are often asked by patients whose close relatives have diabetes. And considering how common this disease is and how many complications it has, they should be considered in detail. After studying this publication, each patient will understand what the disease is, what is the cause of 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 therapeutic profile with a narrow specialization. Among his patients, cases of diabetes are the most frequent. They make up almost 70%. Slightly less often endocrinologists deal with diabetes internists, and even less often – neurologists, ophthalmologists, gynecologists, surgeons and cardiologists. It would be correct to say that almost nothere is a specialist in whose daily work one does not have to meet with diabetes.
Angiopathy in diabetes
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 are microangiopathy and macroangiopathy, a special type of damage to the arteries of the body, causing ischemic manifestations in all tissues.
In the smallest vessels, there is a lesion of the type of multiple aneurysms in combination with hyalinosis. In large arteries, starting from the muscular-elastic ones, it has an atherosclerotic narrowing with the appearance of turbulent blood flows (vortices). In the first case, all tissues at a great distance from the heart suffer, which ensures a violation of cellular nutrition. And in the case of lesions of large arteries, a heart attack and chronic ischemic diseases of the organ supplied by them develop.
The magnitude of angiopathy
Small arteries are present in all organs, and their hyalinosis affects the blood supply and cellular nutrition. Visually assess the defeat of small arteries can be when examining the vessels of the retina. Damage to their walls with ruptures of the smallest aneurysms and areas of hemorrhages are also present in other organs.
This provides specific damage to organs and tissues, such as kidneys, nervous system and brain, heart, skin, muscles. This is indeeddetermines which doctor to contact for diabetes mellitus, because this list contains pathologies of almost all specialists in therapeutic and surgical profiles. It affects the areas of professional competence of a general surgeon and subtherapist, cardiologist, neurologist, ophthalmologist, dermatologist, internist and endocrinologist.
Hyperglycemia
It is the endocrinologist who will deal with the direct 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 disease due to metabolic syndrome and diabetes. It is necessary to determine which doctor treats diabetes in a particular patient based on the existing complications. They should be considered separately in each rubric.
Nephrological profile of diabetes
Kidney damage and the development of chronic renal failure requires treatment by a nephrologist. Initial chronic kidney disease, in which creatinine clearance is not reduced, but urinary microalbuminuria has already appeared, requires constant monitoring by a therapist. It is important to understand that the specialist is not obliged to monitor the patient's he alth instead of him. If a patient really cares about their own he alth, they must follow the dispensary observation schedule, knowing the dates of their scheduled examinations.
This measure is required for dynamic tracking of blood testsand urine, which will make it possible to judge the degree of control of the disease. Such a recommendation for patients with diabetes mellitus will be given by each specialist visited by the patient. At the same time, the main goal of dispensary observation is the early detection of the progression and transformation of chronic kidney disease into terminal renal failure. This is easy to track if the patient actually shows up for appointments and follows the specialist's recommendations.
Ophthalmic profile of diabetes
The ophthalmologist is often the first person to see visual signs of a disease. During the examination (ophthalmoscopy or biomicroscopy), the presence of a vascular lesion will be determined. It is the basis for the deterioration of vision, because with the appearance of pathologies of small vessels, the intensity of the blood supply to the retina is significantly reduced. Its receptor cells die, which causes visual acuity to decrease. At the same time, 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 denied even ophthalmic operations due to the high risk of complications.
Diabetes Surgical Profile
The most annoying part of diabetes is microangiopathy, which mediates the deterioration of tissue healing in case of tissue damage. But malnutrition due to a significant narrowing of the arterial blood 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. Hersurgical treatment in conditions of low regenerative potential requires long-term rehabilitation. There is also a high risk of wound infection, which is also common in diabetic patients.
Endocrinological and therapeutic profile of diabetes
Which doctor defines diabetes and which deals with its treatment can vary significantly. It is not uncommon for an ophthalmologist to suspect diabetes during a routine fundus examination. But more often than others, the first complaints from patients with diabetes or impaired glucose tolerance will be heard by a therapist. Also, due to the fact that the patient must take tests 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.
Regardless of where a particular patient treats diabetes, he will always be in contact with both the endocrinologist and the therapist. The latter deals with the correction of the intake of tableted hypoglycemic agents. The scheme for prescribing injectable drugs (monoinsulin and protamine-insulin) is developed only by an endocrinologist. Their joint work in the endocrinological center of St. Petersburg will delay the aggravation of vascular damage by maintaining stable glycemic levels.
Patient flows
Determining which doctor treats diabetes in a particular patient will be the clinical form of the disease. Type 1 diabetes mellitus associated with absolute insulin deficiency requires dispensary observation and treatmentendocrinologist. This specialist is the main one for a patient with this form of the disease, while doctors of other speci alties will be involved when signs of complications appear.
In the case of type 2 diabetes, an endocrinologist, who treats and eliminates hyperglycemia, will prescribe hypoglycemic agents and monitor the sufficiency of therapy. That is, he will monitor how well the drug therapy regimen is selected. If taking tablets is not enough, then a complete 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, endocrinological diseases, including diabetes, are treated by city hospitals and specialized centers. They have established treatment according to the territorial principle and in the direction of the outpatient link. Patients have access to independent paid treatment in specialized endocrinological centers of St. Petersburg:
- North-West endocrinology center on the street. Savushkina, 124, building 1. or on Kronkverksky Prospekt, 31.
- Regional endocrinological center named after. 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.
- Children's endocrinology is available at Children's Clinical Hospital No. 19 named afterK. A. Rauhfus on Suvorovsky Prospekt, 4.
In the endocrinological centers of St. Petersburg, the treatment of diabetes 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 eating. Diabetes is a disease that is very dependent on nutrition. And when it changes, the treatment regimen should also change.
Unfortunately, such a maneuver is impossible if the patient daily changes his eating habits or violates the rules of nutrition. Any endocrinologist who treats diabetes and its complications will say that a patient with such a disease may not deny himself physical activity, but diet recommendations must be strictly followed. Therefore, when visiting a doctor, you should ask for recommendations on organizing your diet.
Dietitian consultation
A visit to a dietitian is a smart decision. This will allow you to develop approximate menu items, and such recommendations are more detailed, formalized and limited by clear boundaries. Therefore, it will be easier to execute them according to the list, which will ultimately improve the quality of treatment. An endocrinologist or therapist can also give dietary recommendations, however, due to the lack of training in the formation of diets, they will be less effective due to ambiguous understanding of them by the patient. It should be remembered that diabetes requires discipline, and therefore your diet should be organized and constantly strictlyto control. The selection of approximate menu schemes should be individual, which the nutritionist will help to do.
