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Second Opinion on Diabetes mellitus
Diabetes (diabetes mellitus) is an umbrella term for various metabolic disorders. Their common feature is that they all result in increased blood sugar levels due to insulin (a hormone) deficiency and/or its reduced effect. There are two major types of the disease.
Type 1 is caused by an absolute shortage of insulin. It happens because the pancreatic cells fail to produce it, usually in childhood and adolescence. Up to date there is no cure, so patients have to take insulin injections throughout their lives.
In the case of Type 2 disease, the body cells do not respond to insulin (which is called “insulin resistance”). Overproduction of insulin eventually leads to an "exhaustion" of the insulin-producing cells (the pancreas cannot supply enough insulin to meet the increased demand). The disease usually manifests itself unexpectedly. It used to be called an “adult” diabetes; however, in recent years it is becoming more and more frequent among young people and teenagers.
Type 2 diabetes treatment in the initial stages includes the proper diet, regular exercise and correction of body weight. If this is not successful, various medications in pill form are prescribed. Should these not help control the disease, patients have to be injected with insulin.
Relatively recently, novel drugs have come to the aid of diabetes patients, which are not only able to regulate glucose levels, but also to fight the dangerous "satellites" of diabetes - high cholesterol and hypertension. They are considered a significant progress in the treatment of diabetes mellitus.
The pancreatogenic form is a special kind of the disease. It develops in connection with certain pancreatic conditions. Its management requires specific approaches.
How is the diagnosis made?
The basis for diagnosing diabetes is a careful analysis of the clinical presentation and laboratory blood tests.
Type 1 diabetes usually becomes noticeable very quickly with symptoms such as a strong urge to urinate, thirst, and fatigue, and is usually fast to get diagnosed.
In contrast, type 2 diabetes often remains undetected for a long time. Its symptoms usually develop insidiously, so that those affected do not notice them. They get used to the signs without perceiving them as abnormal. It can therefore take up to ten years for the disorder to be identified. Meanwhile, secondary diseases occur as a result of the permanently elevated blood glucose levels.
Is one doctor opinion sufficient in diabetes mellitus?
Given the variety of therapies and approaches available, diabetes mellitus is a condition in which one could always do with additional counseling. Even if the disease seems to be under full control, it is worthwhile to make sure that no new, more effective therapies have already emerged. This is all the more true whenever the ongoing treatment of diabetes does not bring the desired result.
What questions and issues can independent expert advice deal with?
The advice of an experienced specialist can help in a variety of situations and at a variety of stages of the course of diabetes mellitus.
Diagnosis
Although the disease is widespread and well understood, doctors are not always able to recognize some specific types of diabetes mellitus. In particular, it can be difficult to identify pancreatogenic diabetes, the treatment of which requires a specific approach. Therefore, at the slightest suspicion of inaccuracy, it is worth contacting a more competent diabetologist.
Treatment
Cases of diabetes mellitus may be an issue for additional counseling when:
- there is doubt as to what the optimal (i.e., target) sugar level for the particular case is;
- the target glucose levels cannot be achieved despite treatment;
- there are concomitant chronic diseases;
- you are considering the use of new drugs, which are not yet common practice for every physician.
What will the client get?
Our expert, upon careful analysis of the diabetes mellitus patient data, shall provide:
- Their own assessment of the situation, including the confirmation, refinement, or refutation of the existing diagnosis of diabetes mellitus, as well as comments on the sufficiency of the available examination findings and their interpretation.
- Answers to questions prepared in advance or arising during the online conversation.
- Recommendations for further actions, which may include continuation of the current therapy or its modification, lifestyle and/or diet correction, additional diagnostics and/or referral to specialists in concomitant diseases.
What data should be provided to get a second opinion?
The amount of information required is to be specified on a case-to-case basis. The primary list shall include:
- blood (fasting glucose, glycated hemoglobin HbA1c, creatinine, cholesterol, triglycerides) and urine (albumin) lab test results;
- a list of current medications, including dosages and frequency of administration.
If available, it is also advisable to provide:
- A written opinion of your physician (general practitioner or endocrinologist);
- Glucose tolerance test results;
- ECG and echocardiography findings;
- Abdominal and vascular ultrasound exam reports.
What are the formats of remote advice for diabetes mellitus?
Written counseling:
Review of the available medical data of diabetes mellitus patient, provided in writing. The report shall contain the overall assessment of the situation, as well as conclusions and treatment recommendations.
Basic size: up to 1 page.
Video appointment:
All services included in the written consultation. Above them, a video appointment with the doctor, where he/she shall perform a visual inspection, if necessary; clarify the diabetes symptoms, comment on the diagnostic and functional radiology tests findings, explain the proposed strategy and answer the patient's questions.
Duration: up to 15 minutes.
Telephone consultation:
All services included in the written consultation. Above them, a phone talk with the doctor, where he/she shall clarify the diabetes symptoms, comment on the diagnostic and functional radiology tests findings, explain the proposed strategy and answer the patient's questions.
Duration: up to 15 minutes.
Specialists in Diabetes mellitus
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