Diabetology - Medical specialists

Endocrinology and diabetology actually belong together. After all, a very large number of specialists in this field are "specialists in internal medicine with a focus on endocrinology and diabetology". This in turn refers to six years of additional training. But not all diabetologists have the main focus on endocrinology at the same time, because specialists from other disciplines can also obtain the "additional qualification in diabetology".

Since diabetes in all its variants is a very common disease, it alone deserves a lot of attention. Whether it concerns adolescent diabetics, type 1 diabetics or adult-onset diabetes or gestational diabetes - each form requires its own therapy.

What all forms of diabetes have in common is a deficiency of the hormone insulin. This is why diabetes is usually classified as a hormonal disease. The most common form of the disease is "diabetes mellitus", divided into type 1 and type 2 diabetes - with around 90% of patients suffering from type 2. Inadequate nutrition and lack of exercise lead to a sometimes dramatic increase in diabetes, particularly in industrialised countries.

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Diabetology - Further information

As a sub-field of endocrinology, diabetology addresses the prevention, diagnosis and treatment of diabetes mellitus and also research into it. Doctors who have specialized in this field are called diabetologists.

Activities of a diabetologist

Diabetologists are specialists who have specialized in the treatment of diabetes mellitus. Both children and adults are treated equally. The specialism covers the following diseases:

  • diabetes mellitus type 1
  • diabetes mellitus type 2
  • pregnancy-induced diabetes

Also covered are the following possible secondary conditions:

  • hyperglycemic shock
  • hypoglycemic shock
  • diabetic nephropathy
  • diabetic foot syndrome
  • diabetic polyneuropathy
  • diabetes-induced eye diseases (referral to an ophthalmologist)

which are part of a diabetologist's scope of expertise or that of a general practitioner with the appropriate additional training.

Here, however, diabetologists engage not only in diagnosis and treatment but also supply long-term medical counseling and support, deliver training and also emergency care for diabetic patients.

The classic remit of a diabetologist

Diabetologists treat both patients with diabetes mellitus which has already been diagnosed and patients where a diabetic disease is suspected.

Diagnosis involves multiple measurements of blood sugar on an empty stomach and an oral glucose tolerance test (oGTT). Also, a urine sample can provide clues as to the presence of a diabetic condition.

If diabetes mellitus has been diagnosed, your diabetologist may well offer you various training options in connection with the treatment. This is for you personally or also for your children. Here you will learn which food is important, how to measure your blood sugar levels yourself, how and when to take medication or to inject yourself with insulin.

If you need an insulin pump which automatically delivers insulin without any action on your part, your doctor will also give you detailed and specific advice.

To be able to check the course of your diabetic condition regularly, your diabetologist will carry out regular reviews in which he will take blood samples and determine both the blood sugar level and the HbA1c reading (long-term blood sugar). This figure give the mean value of your blood sugar levels during the past two to three months and provides clues as to the precise course and to what extent the medication may need to be adjusted.

As part of the reviews, the doctor will keep watch for possible secondary diseases and, if necessary, will refer you to other doctors (e.g. ophthalmologists).

In emergency care, the diabetologist will also treat patients with hypoglycemia (low blood sugar level), for example if they have not eaten for some time. In this case, they receive a sugary infusion to bring the blood sugar level back to normal again.

Training and further training to qualify as a diabetologist

First, the basic medical course of study lasts twelve months and three semesters. If a medical student passes the examination, he is awarded his license to practice as a doctor and can then train to qualify as a specialist in internal medicine. This requires a further five years of study.

Once the qualifying examination for the status of specialist is passed, further training in various fields becomes possible. This enables the doctor to acquire the relevant additional titles. Once the further training in the field of diabetology has been successfully completed, the doctor becomes a 'Specialist in Internal Medicine' with the additional title of 'Diabetologist'.

Where do diabetology specialists work?

First of all, diabetologists can of course work independently in their own surgeries, where they carry out diagnosis, treatment and emergency care.

However, it is always possible to work in an employment situation as an employed diabetologist in a major specialized medical practice or hospital. 

In recent times, many clinics have also specialized in care for diabetic patients. Support and treatment in these clinics is delivered by diabetologists.

Assistance vocations in the specialist field of diabetology

As well as diabetologists, there are also vocations as medical assistants, for which the German Diabetes Association offers further training schemes.

These include:

  • diabetes counselor
  • diabetes assistant

Both vocations have a part to play in the support, counseling and training of diabetes patients. Diabetes counselors generally work independently and must provide evidence of one year of work in the support of diabetes patients under the supervision of a diabetologist. A diabetes assistant primarily trains and counsels patients with diabetes mellitus type 1 and aids the doctor in his support of patients with diabetes mellitus type 1.

For both further training options, a completed course of training in a particular vocation (at least doctor's assistant, occupational healthcare worker or medical orderly, geriatric nurse) is an essential basic requirement.

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