2

I am from IT domain and would like to seek some help on certain medicine related questions

I would like to know how does Diabetic specialist hospital/clinic work for Diabetic patients when compared to any other non-specialist hospitals (for treating diabetic patients)

1) Why do people visit specialist clinic? What is special here? Isn't it because primary care physician is not experienced enough in treating diabetes?

2) It's not necessary/mandatory for a patient to visit diabetes specialist clinic when he could get the treatment from any primary care physician. Am I right?

3) Let's say we have patient A who has been diagnosed for diabetes and been referred to a diabetes specialist clinic by his primary care physician. So Am I right to understand that patient A will keep visiting diabetes specialist clinic only for complications related to Diabetes like blindness, cataract, nephropathy etc. or can he visit for anything (medical condition or whatever) unrelated to diabetes?

4) Let's say we have a database of patients from diabetes specialist clinic. This database will only contain info about their visits to diabetes specialist clinic, complications diagnosed for diabetic patients,Drugs prescribed for diabetes complications etc.

5) For example, if I look at the database for T2DM and T1DM drugs (drugs for T2/t1 + associated complications), does it mean all patients (100%) who visited the diabetes specialist clinic will have this info? Because they all are diabetic patients? They ought to have these drugs. Can a patient be treated without prescribing drugs?

6) Is it possible that patients visit diabetes specialist clinic but may not have the T1/T2 drugs? But they are prescribed other drugs unrelated to T1DM and T2DM?

If yes, for what sort of conditions do they get prescribed for? Is it possible that diabetic patients contain more than 80% of NOT T1 and T2 drugs.

Can you help me with this?

2

You pretty much answered your questions, except for 5 and 6.

1) Diabetes is a serious disease, so it needs to be diagnosed accurately and complications detected early (some people will already have complications at the time of first diagnosis). All this requires investigations for which a primary doctor doesn't have equipment/experience and time. Also, from all available drugs, a specialist (endocrinologist) needs to figure out an exact type and dose of a drug appropriate for a given patient, which may involve a stay in a clinic.

2) The exact diagnosis should be given by an endocrinologist when possible. When appropriate treatment is prescribed by a specialist it can be then monitored by a primary doctor - which is the usual practice.

3) Yes, a patient will visit a clinic for complications, but because a patient may not be able to detect some complications early enough, a specialist may ask a patient to have a control once a year, for example, even if a patient doesn't have any complications. A common reason to visit a clinic is also to ask for a change in treatment regime (for other types of drugs/insulin).

4) A specialist of any kind should have access to a complete medical record of any patient visiting him/her. Some diabetic complications need exact diagnosis by other specialists (cardiologist, neurologist...) and they are these specialist who can prescribe appropriate drugs.

5) and 6) A patient with diabetes type 2 (but not likely type 1) visiting a diabetic clinic may have no drugs prescribed at any time and can be treated solely by a diet and other lifestyle measures. Some patients may initially get some drugs, which can be later discontinued, because they don't need them any more. And some patients will have no drugs for diabetes, but for other conditions, like high blood pressure, prescribed by an endocrinologist or other specialists and all those drugs should be in a database accessible to an endocrinologist. It is also possible for an endocrinologist to prescribe non-diabetic drugs, for example:

If you say that diabetic drugs include only oral glucose-lowering drugs and insulin, then, yes, it's possible that, in the database, you see 80% of drugs that are not strictly for diabetes.

| improve this answer | |
  • Hi Jan. Thanks for the response. upvoted. Can we say that whether the below sample drugs are PREDNISOLONE - 20 MG - TAB EXTERNAL PURCHASE (IBANDRONIC ACID 150MG) DEXTROMETHORPHAN 15MG/5ML LINCTUS 90ML Ezetimibe 10mg tab 30's BN: 4EZPA23005 Exp: 30 Sep biSOPROlol-TABLET PRAVASTATIN 20 MG TAB bumetanide-TABLET prednisoLONE-TABLET are not T2 or T1 drug? but Oral glucose lowering drugs? – The Great Jan 16 at 10:28
  • None of the above drugs is for diabetes. You can highlight the drug, right click: "search in Google" - and you'll see from Google results (without the need to search further) what type of a drug it is. – Jan Jan 16 at 10:32
  • Yes, exactly see. for example I see pravastatin 20 MG is used to lower bad cholestrol. Isn't that for diabetes? By bad cholesterol, I assume it is obesity etc. So isn't drugs used to treat complications aren't considered as diabetes drugs? – The Great Jan 16 at 10:48
  • Hm, no. "Drugs for diabetes" involve only oral hypoglycemic drugs and various types of insulin. Even if high cholesterol is common in diabetes, the drug pravastatin, which lowers cholesterol, is "cholesterol-lowering drug" not a drug for diabetes. If you have more specific questions about drug categorization or such, you may want to open an additional question. – Jan Jan 16 at 10:54
  • Got it. Will read further before I post a question on drugs. But May I confirm my understanding with you that patients who come to Diabetes specialist clinic need not be prescribed diabetic drugs like you mentioned above in point 5 and 6 (Oral hypeglycaemic and types of insulin) but other drugs for other conditions like cholesterol, blood pressure which can help maintain a healthy lifestyle and cure diabetes? if not cure, then keep diabetes in control. AM I right? – The Great Jan 16 at 11:07

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service, privacy policy and cookie policy

Not the answer you're looking for? Browse other questions tagged or ask your own question.