Building Your Team: The Specialists who Treat Diabetes

By Rebecca McKinsey

Diabetes is incredibly complex, as is its treatment. Because of that, managing diabetes typically involves a team of health care professionals.

“There’s no one clinician who can do this all,” explains David G. Armstrong, DPM, MD, PhD, professor of surgery at University of Southern California’s Keck School of Medicine and founder and co-director of the Southwestern Academic Limb Salvage Alliance (SALSA). “Thinking that is old-style thinking. This is a team sport. You need to team up to make a difference here, to keep moving through the world a little better every day.”

These are some of the providers who may be involved in your diabetes care.

— Primary care physicians, physician assistants, nurse practitioners, or advanced registered nurse practitioners: Often the first medical provider you see for diabetes or diabetes pain care. They can help with prevention, monitoring, treatment, identifying problems, and referring you to specialists.

— Podiatrists: Offer foot and ankle care and typically are versed in diabetes-specific issues such as loss of sensation and wound care. They are trained to monitor for early signs of diabetic peripheral neuropathy (DPN).

— Foot care nurses: Specialize in foot care and are certified through the American Foot Care Nursing Association. They sometimes offer in-home care for individuals who have difficulty getting to appointments.

— Endocrinologists: Specialize in metabolism, hormones, and glands—including the pancreas, which produces insulin, making it key in diabetes treatment. They are one of the most common diabetes specialists.

— Diabetologists: Specialists, typically endocrinologists, who have undergone additional training and exclusively treat diabetes. There is a national shortage of doctors specializing in diabetes in the United States, and only two diabetologist fellowship programs in the country.

— Certified Diabetes Care and Education Specialists (CDCES): Work with individuals to create a plan to manage their diabetes.

— Dietitians or nutritionists: Help create a diet and nutrition plan specific to the needs of those living with diabetes.

— Physical therapists or fitness professionals: Build a tailored exercise regimen to help people manage their diabetes.

— Neurologists: Treat neuropathy and neuropathic pain such as DPN, identifying nerve damage and working to keep it from progressing. In some cases, a neurosurgeon may perform surgery to treat neuropathic pain.

— Vascular specialists or surgeons: Manage and treat vascular problems caused by diabetes such as atherosclerosis (hardening of the arteries) or peripheral artery disease (PAD).

— Optometrists or ophthalmologists: Treat eye diseases or problems that can accompany diabetes.

— Pain management specialists: Help find solutions for managing diabetes-related pain such as DPN.

— Mental health professionals: Include psychiatrists, psychologists, therapists, and counselors. Some specialize in diabetes, but many are able to help treat the mental health challenges that may go hand-in-hand with living with diabetes.