Should you discuss with your doc that you want to see a specialist?   (January 14, 2009)

I received the following e-mail, and thought the subject was one that might resonate with some of our readers: should you discuss with your present physician that you want to see a more knowledgeable specialist.

"I have a very good GP. He is also a pain specialist which helps me with my severe back and sciatic pain. He is a friend.

"He has tried several treatments (pills) that didn't work for my diabetes until settling on Lantus (I am up to 30 units) which is working except for I am experiencing the "dawn syndrome". I am reading pretty much 150 all through the night and morning. I have read that this is probably "dawn syndrome" and not the "Somogyi effect".

"My doc has not mentioned either of these to me as a possibility of the cause. I found this out on my own from reading on the internet. Finally, my question: Should I seek help from an Endocrinologist to manage my diabetes?

"I can't afford to ruin the good relationship I have with my GP. I live in a small town but I think he may have dropped the ball here."

My reply:

"This is always a tough situation, but I'd vote for you seeking additional help. Perhaps you could mention to your GP that you would appreciate a referral to an endocrinologist that he knows and trusts, and make it clear that you do NOT intend to "jump ship" and discard your present relationship.

"If you do see an endocrinologist, insist that the endo coordinates with your present doc: for instance, that he notifies your present doc of any new proposed therapies.

"Best wishes; let me know how things turn out."

Also, I've previously written a discussion of When to refer to an endocrinologist that the reader might want to review.