Understanding Endocrinology and Diabetes

What is an endocrinologist?

An endocrinologist is a medical doctor that specializes in the study of hormones and treats hormone-related conditions, including: diabetes, thyroid disease, under- or over-production of certain hormones such as testosterone, osteoporosis, cholesterol disorders and various cancers of the endocrine glands. The most common thing they treat is uncontrolled diabetes.

What is diabetes?

Diabetes is a chronic medical condition characterized and defined by high levels of sugar in the blood. It is caused either by an inability to produce insulin, which is needed for the utilization of sugar, or an inability of the body to effectively use the insulin it produces. Long-term management is crucial as there can be long-term serious complications including heart disease, kidney disease and neuropathy.

What is the difference between type 1 and type 2 diabetes?

Type 1 and 2 diabetes can be thought of as a spectrum of conditions rather than two distinct entities. Type 1 is typically considered to be an autoimmune condition where the immune system attacks the insulin-producing cells in the pancreas leading to a complete insulin deficiency. Type 2 diabetes is considerably more common and is characterized by insulin resistance, so the body is making insulin but not responding to it adequately.

Who is most at risk for developing diabetes?

For type 1, family history is an important risk factor as well as the presence of other autoimmune conditions. For type 2, the major risk factors are being overweight or obese, older age, having family history and living a sedentary lifestyle, as well as belonging to certain ethnic groups such as African-Americans, the Hispanic/Latino population, and Asian-Americans. Additionally, women with a history of gestational diabetes or polycystic ovarian syndrome are at much higher risk. Unfortunately rates of diabetes continue to rise in both older and younger adults.

What are some treatments for both types of diabetes?

Lifestyle modification is the cornerstone therapy both in type 1 and type 2 diabetes. We’re living in an exciting time for this condition as technology has revolutionized its management. Type 1 has traditionally been treated with multiple daily injections of insulin, but now there are smart insulin pumps that can continuously infuse the medication and employ algorithms for adjusting its dose and delivery.

For type 2 diabetes, there are now a number of new non-insulin regimens that improve glycemic control and target long-term complications such as heart disease and kidney disease. In those camps, continuous glucose monitoring has completely changed the game. Instead of having to stick your finger and check your blood sugar multiple times a day, continuous glucose monitors go in the back of the arm and can read out sugars continuously over the course of the day. It is a phenomenal accountability tool and also crucial in helping providers measure and adjust patients’ medication safely and target specific problem areas.

Alexander Markov, MD is a board-certified endocrinologist. He is part of BJC Medical Group of Missouri and sees patients at Barnes-Jewish St. Peters Hospital and Progress West Hospital.

To schedule an appointment, please call 636.928.WELL (9355).

Learn about diabetes and endocrinology: https://www.bjc.org/specialties/diabetes-and-endocrinology