Less TD1 endocrinologist than type 2

I have lived and Atlanta, Pittsburgh and Miami and found out that’s true what a senior endocrinologist in Atlanta mentioned. She mentioned that few new graduated doctors are specializing in Diabetes type 1 because how complicated and time consuming treatment is. I imagine they make less $$. Two very good doctors that my family knows have switched to thyroid and type 2.

Sometimes on the forum you see recommendations about “being your own doctor” - here’s a good reason to follow that advice. Still, it can be helpful to get a second opinion now and then.
I know a couple of women who are Nurse Practitioners specializing in diabetes care - I wonder how much of a gap might be filled by those titles🤔?

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I have an endocrinologist but Ive only met her once. I only see my nurse practitioner (she’s awesome). She prescribes all of my insulin and supplies, and makes all my management decisions. I think (don’t quote me on this) most diabetics at my clinic see nurse practitioners.

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Same for me. My prior nurse practitioner did everything including prescription etc; however, there’s a reason why physicians have to follow a rigorous study before they become doctors then complete the specialty. As a teenager my head endocrinologist used to see me with some doctor working on their specialty or getting experience on it. Final say was always the endocrinologist. I think it’s a matter of $ and patients are getting the short stick. A nurse practitioner is never the same as a physician. That’s my opinion anyway.

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I’ve always wondered where the cutoff was between a nurse practitioner and a medical doctor. Of course I know there is one but I wonder what the MD can do medically speaking that the NP cannot within their area of specialty.

I suddenly developed diabetes at age 70. (A month after a physical at which my glucose was just slightly high, I was admitted to the ICU with glucose over 1000.) My doctors assumed it was Type 2. After 6 months of not being able to get my glucose balanced, they sent me to an endocrinologist who immediately concluded that I was likely Type 1, tested me, and determined I was in fact Type 1.

Since then, the HMO gave me a pump and CGM. I see the endocrinologist about twice a year to keep an eye on my glucose levels, give me advice about what may be causing me to go out of range,etc. I deal with a nurse concerning supplies and routine matters. The arrangement seems to work well.

At Kaiser, the HMO to which I belong, it appears that Internal Medicine doctors care for the Type 2s, and send them to an endocrinologist only if there is a problem the Internal Medicine doctor does not feel comfortable handling.

In any event, I seem to be getting excellent care.