I am looking into getting a different Endo, and I am wondering what questions you might ask, if you were looking for another Endo. I am newly Dxed with Diabetes, but also have Graves. So I really need the advice of a specialist in these feilds. I don't have alot of doctors to choose from here(as my other Endo is 2 1/2 hours away) this one is closer, but I know nothing about him other than he practiced here before and that he is on the same hospital board as my regular MD. What type of questions did you ask your Endo? Any help would be great! Thanks in advance.

Hi, right now is an especially good time because there is a particular question which will tell you A LOT about how they keep up on Diabetes:

" What do you know about the new Continuous Glucose Monitor Systems? "

Best possible answer: "I've tried both the Minimed 722 R/T (pump with CGM) and the Dexcom (stand-alone CGM), here's what I feel after actually using them...." The "best possible answer" should also include items I list as "Next best answer".

Next best answer:

"I've heard and read about both the Minimed and Dexcom devices, which are available already, and the Abbott, which may become Approved shortly. The Abbott is supposed to be completely waterproof, which is a nice feature... with Minimed and Dexcom, you have to protect the Sensors with "shower cover" plastic stick-ons every time you take a shower. Although the costs of using them in accordance with the FDA approvals is extremely high and not covered by insurance, the Sensors can be used for multiple periods, so it doesn't really blow $4000 of your money every year just to replace the Sensors (every 3 days per FDA). In the case of the Minimed, you might get some insurance coverage as a pump, and Minimed might offer us some money via their upgrade program...." If he/she doesn't know that the Sensors last way longer than the FDA says, that's a really bad sign. It means they've seen some Marketing stuff, but don't know a critical fact which EVERYONE should know. It would be like going to a GP/Internist who never heard of an extremely effective "off-label indication" to treat one of the illnesses you're likely to present in the future.

He/She should also ASK YOU about the glucose excursions and A1c which you have, to help determine if a CGM is appropriate. (It is most appropriate for people with suffer lots of unexpected lows, especially at night.)

So much for the CGM question, I think that question really divides the good diabetes Endos from the average (and below average) ones.
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Other questions I would ask:

(1) Are you Board Certified? It's REALLY TOUGH to pass the board certification tests for most Specialties. Most practicing "Specialists" HAVE NOT earned Board Certification. (They HAVE successfully completed their Residency requirements, but they've either failed the Certification exams or not even bothered to try taking them.) I personally require Board Certification for all of my Specialists, although such a Physician may not be available in your area. But if it's between an un-Boarded Endo who does know CGM and a Boarded Endo who doesn't know CGM, the Un-Boarded one who knows about CGMS would be the winner for me.

(2) Do you specialize in pancreatic disorders, or do you also work with OTHER organs of the body? (Some work with other organs is certainly OK. But my Endo's partner is nationally respected for working with a DIFFERENT gland entirely, AFAIK he doesn't do Diabetes at all!)

(3) Do you and your educator work with the ADA "balanced" (i.e. high-carb) diet exclusively, or do you work with "low-carb" lifestyles too? What do you think of that Duke study? This tests both their compatibility with low-carb AND their currency on diet research: the study result was, OVERWEIGHT type-2s lost more weight and got better improvements in all blood diagnostics (A1c, total Chol, HDL, ratio, and even triglycerides) when intensively trained in a low-carb diet, rather than the ADA diet).

(4) What sort of A1c targets do you set for your patients? (ADA = 7.0, but AACE is all the way down at 6.5. (If an ENDO isn't trying for the AACE guidelines, that's kinda weak IMO. Although barely 1/3 of diabetics even meet the ADA standard. The Dr. should indicate that it's really up to the pt. -- he/she can instruct, measure, assess, enable, and encourage, but your results are really up to YOU, not HIM/HER.)

If you are Type-1: (5) What proportion of your patients are Type-1? Ask this question because you're looking for a Dr. who spends a lot of time treating similar pts.

Then finally, assess how you just plain FELT while talking with that Doctor. Your subconscience and emotions are very "smart" parts of your head, listen to them!

Re-reading YOUR post, I see that you SHOULD be looking for an Endo with a substantial practice in Graves disease (hyperthyroidism). If you haven't already had your Thyroid knocked out, then You should also ask questions like:

Does he/she prefer to try the less aggressive Anti-Thyroid drugs before going to iodine or surgery? How frequently will you have tests to assess the success (or non-success) with this approach?

How does she/he choose between I-131 and Surgery?

(MOST IMPORTANT!!) How many pts. has he/she taken through I-131 and Surgery in the last year (two different numbers).

(SECOND MOST IMPORTANT) Do you perform Iodine and Surgical treatment yourself, or refer me to a medical center? (If so, WHICH DR. AT WHICH CENTER?... WHAT IS HIS EXPERIENCE AND QUALIFICATIONS?
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If you've already on Thyroid replacement (or are facing that possibility in the future), what is the Dr's protocol for setting replacement medication dosages and monitoring Thyroid Hormone levels in the future?

Thanks so much you are always so helpfull. I have already done the I 131(three years ago) and I am on thyroid replacement, but am still having problems with the Graves due to eye issues. So me having both thyroid and diabetic issues on board, are one reason I am looking into another Endo, other than the one that is currently treating me. Thanks again!