Top Questions to Ask Your Endocrinologist

Preparing for Your Appointment

As patients, sometimes it is difficult not to be nervous around doctors. They always seem so busy, and it can feel like you’re infringing on their time with so many questions needing answers. However, managing diabetes - monitoring diabetes medication, keeping blood glucose levels in check and following a wide range treatment plan is no easy task.

What is the most important thing to remember?

Knowing they are working for you to help you feel better is essential when you’re in a room with your physician. In addition, you and your insurance company are paying for their time. If your current health care provider is not finding solutions for your blood sugar control, other physicians can.

Around the time I was searching for the right endocrinologist, I had at least seven visits with different providers to find the right fit. The most vital thing to me was finding someone who would look at my medical history, correctly answer essential questions, and be thorough in their review of my medication conditions and whatever prompted my visit.  

Ask Questions!

Endocrine disorders can be complicated. The endocrine system, endocrine glands, and adrenal glands all require much attention. Medical conditions like diabetes take due diligence not only to monitor daily but quarterly as well. Blood sugar levels are checked 24 hours a day and then every few months with a simple blood test called the A1C or hemoglobin A1C. The A1C test measures average blood sugar levels over the past two to three months. 

Before meeting with a provider, jot down questions about any pains, growth disorders, blood sugar level issues, or insulin pump problems you are experiencing. I like to ask about new diabetes devices, medications, and the latest advancements in type 1 cures.

With a piece of paper or question on my phone, it helps to double-check your list while meeting. Also, make sure to have a list of all the medication prescriptions (insulin, test strips, insulin pump/pen and continuous glucose monitor (CGM) supplies) you need to renew.

Type 1 Diabetes (T1D) Questions

• If you experienced any weight gain, what type of physical activity should you be doing? How many days a week? And how long?
• Request thyroid blood tests in addition to your A1C test. Thyroid disorders can sometimes be connected to T1D.
• What is the outlook for a type 1 cure?
• Discuss your family history as well as your own medical history.
• Is my A1C test results within the goal range? If not, ask what adjustments they feel will lower it.
• How can I stabilize my blood sugar control and get feeling better?
• What are these tests for? Depending on your symptoms and history, your doctor may order various endocrine system tests.
• What meal plan should I follow for the best blood glucose results? 
• Can a dietician on staff help me with my food choices?
• Will this condition continue throughout generations of my family, and should we partake in the clinical trial or screening to detect diabetes-related antibodies?‍

Interesting Fact: The new drug, Tzield, works to slow the progression of type 1 diabetes, delaying the need for insulin treatment – in some cases, up to two years.

• What type of T1D advancements are coming to fruition?
• Is there a different insulin delivery system that will work better for me?
• Can I slow down the destruction of the beta cells?
• Are there any additional side effects or conditions I should be concerned about?

Medication Questions 

Write any concerns or questions you have about your medications before your visit. If you have just been diagnosed with a new condition in addition to T1D, you need to understand alternative treatments outside of your prescribed medications. 

Also, be sure to ask the following: 

• What time each day should I be taking the medication?
• What, if any, side effects might I have? Growth disorders?
• Is there a possibility of dizziness or weight gain?
• How long will I need to take the medication?
• Is there any other medication that might work better?
• Will this affect other aspects of my life?
• If the diagnosis is unfamiliar, ask what you should do regarding diet or physical activity to help improve the condition.
• How long will this condition last? Is it going to be permanent?
• Are there any other medication(s) that I can take?
• Is a homeopathic treatment available?
• Is there a specialist I should see?
• Will any other medications I take interact badly with T1D and cause my blood sugar to go high or low?
• Is there any other treatment plan I can follow to aid my condition?  

Dual Diagnosis

Since T1D is an autoimmune disorder, secondary medical conditions like celiac, Hashimoto’s disease and polycystic ovary disease may develop. Always write down anything new you have been feeling or experiencing and discuss your family history with your physician.

If you have any issues, ask your healthcare team to do blood work or onsite testing to explore answers. Other dual diagnoses associated with endocrine disorders like type 1 diabetes include thyroid diseases, ADHD, and eating disorders.

Blood Pressure Testing

Doing a sitting and standing blood pressure would have prevented a painful broken femur for me. When I went to the doctor complaining of feeling dizzy when I stood, they checked my sitting blood pressure, which was expected, and that was all that was done.

The problem? The significant drop in blood pressure only happened when I stood, which was never checked. One evening, it dropped significantly, and I passed out. When I woke, I had a horrible and excruciating break to my femur that took several physical therapy sessions and months to heal completely.

Additional Diagnosis for Secondary Conditions

• Should I get tested for any additional disease or condition?
• Can I reverse it or do something to make it easier to manage?
• Are there additional symptoms that I should watch for?
• What tests are involved in identifying this condition?
• How accurate are the tests?
• How long will I need to wait to get results?
• Will I need more medical tests?
• Do I need a follow-up visit, and if so, when?
• Are there precautions I should be taking to avoid infecting others?
• How will this disease or condition be treated?
• What is the short and long-term forecast?

When I see my provider, I appreciate that they listen closely to my concerns and have information to help remedy or improve the problem. Fortunately, after many years, I finally found a nurse practitioner (NP) who has helped me significantly. She listens well and methodically works through “what will work best”? She then communicates with thorough explanations and adjustments, and it’s a starting point for getting and feeling better.  

In addition to insulin, I have other medications that can make my blood sugar rise a bit higher. I also have hypoglycemia unawareness, brittle diabetes, and blood sugars that often drop rapidly. It became dangerously terrifying, and I went to several physicians, and several more, and then more. It became a mad quest to find a solution and get this portion of my life in control. 

Thankfully, with her help, my blood sugar level has been more stable now than it has been for the last 30 years. Before this appointment, I had a written list of questions to which I received terrific answers. Most importantly, the nurse practitioner also listened to my biggest concerns (hypoglycemia), gave me the best advice, reset my equipment, and explained various ways that I could manage to get this under better control.

The best thing? She had answers to most of my questions and searched for answers to others she initially didn’t have.

Double Check

Once again, managing diabetes is challenging for all involved. Your diabetes management should garnish a wide range of professionals (physicians, nurses, nutritionists, pump specialists) willing to help.

When unfamiliar medications are prescribed, you need to understand how the new medications are working and whether they are likely to cause reactions. Most importantly, before you leave, schedule a follow-up appointment to receive your test results and see if you have been prescribed diabetes medication.

Sometimes conditions can be overlooked. It’s essential to have a provider knowledgeable about the “variables” around diabetes. When challenging news catches us off guard, we need to schedule a follow-up appointment to ensure we’re of sound mind and can absorb pertinent information. It’s okay to request the doctor repeat what they said.

Ask away and make sure you feel comfortable with the answers!