Endocrinologist? (I found a winner -- thank you!)

If you can deal with going to a doctor in the city, I really like Dr. Sanjay Kinkhabwala at Murray Hill Medical Group - they are affiliated with NYU and he's just teriffic. Super-smart and a very nice person as well. If he doesn't take your insurance, Dr. Anjali Grover is quite good too (same practice).

leighan said:

i just started with anna kissin in florham park. 973-665-8100.
i liked her well enough and her office staff was fantastic! (the reason i changed from my last endocrinologist. his staff was horrid)

I went to her last year and I just cannot afford her fees every 3 months. She also took me off my Armour Thyroid and put me on Synthroid which provided a negative effect.

One thing Dr. Advani enlightened me on is that I was on Janumet, which I now find the FDA is researching as a possible cause of pancreatic cancer. Anna Kissin kept me on it, with the only change being the timed release pills.

jersey123 said:

If you can deal with going to a doctor in the city, I really like Dr. Sanjay Kinkhabwala at Murray Hill Medical Group - they are affiliated with NYU and he's just teriffic. Super-smart and a very nice person as well. If he doesn't take your insurance, Dr. Anjali Grover is quite good too (same practice).

I was just looking online on UHC to see their network doctors and I remember his name (thinking "Sanjay Gupta"). Thanks for the referral. I'm in NYC so it's equally convenient.

mumstheword said:

jersey123 said:

If you can deal with going to a doctor in the city, I really like Dr. Sanjay Kinkhabwala at Murray Hill Medical Group - they are affiliated with NYU and he's just teriffic. Super-smart and a very nice person as well. If he doesn't take your insurance, Dr. Anjali Grover is quite good too (same practice).

I was just looking online on UHC to see their network doctors and I remember his name (thinking "Sanjay Gupta"). Thanks for the referral. I'm in NYC so it's equally convenient.

Really, I think he's the best! I've sent several diabetic friends to him and they've been quite happy. Good luck to you.

jersey123 said:

mumstheword said:

jersey123 said:

If you can deal with going to a doctor in the city, I really like Dr. Sanjay Kinkhabwala at Murray Hill Medical Group - they are affiliated with NYU and he's just teriffic. Super-smart and a very nice person as well. If he doesn't take your insurance, Dr. Anjali Grover is quite good too (same practice).

I was just looking online on UHC to see their network doctors and I remember his name (thinking "Sanjay Gupta"). Thanks for the referral. I'm in NYC so it's equally convenient.

Really, I think he's the best! I've sent several diabetic friends to him and they've been quite happy. Good luck to you.

Fingers Crossed!

Caliope: Dr. Prus is now at the Empire Medical Group. There office is next to Seth Boyden School, just before you get to Springield Avenue.

Thanks, Joan. I am in sort of a Catch-22until November, when I once again will be able to choose my own physician.

My husband uses Dr. Shari Mintz who is in Denville, NJ but is lovely and wonderful (and takes UHC). He had very uncontrolled diabetes and his A1C is not only under control but his energy has improved and his sugar is close to normal. It has been a long road and she has been very patient with patient compliance (sigh). I know hours can be challenging but finding the right person, particularly with diabetes, is so unbelievably important. Dr. Mintz has gotten my husband to take his diabetes seriously which has been a blessing to our family and quite literally might end up being a lifesaver. Hours might be a challenge - I'm not entirely sure what her schedule is because he works in NJ, but she does quarterly visits typically and is very effective at getting things under control. Highly recommended.

mumstheword said:

lixouri said:

I like Dr. Amy Toscano-Zukor at Summit Medical Group very much, and she is on United.

hauscat said:

I currently go to Dr. Toscano-Zukor and find she ignores most of my symptoms. I am looking to switch as well.

She is (in a word) HORRIBLE! I went to her twice. In her arrogance, she wanted to prescribe insulin for my Type II diabetes. I asked her to test my insulin levels, which really got her shackles up. I had to literally demand she test my insulin levels and finally she relented. They came back so abnormally high it wasn't funny. When I brought this to her attention (she wasn't even mentioning it during my follow up appointment) she said to me "don't you think I know what I'm doing?" and my answer was "obviously not"

I know this is kind of old, but...

What's "arrogant" about prescribing insulin for Type II diabetes?

As for Advani, I didn't care for her much (especially when I had to tell her to keep her kind of crazy anti-Obama opinions to herself), and I found her office staff kind of incompetent. But this was a few years ago. I assume the anti-Obama feelings are the same.

I see David Garbowit at the moment, who I like, but certainly isn't holistic, though I'd be hard-pressed to actually describe a holistic endocrinologist.

Ok, NOT holistic, but a great endocrinologist - Dr. Thomas Chon in Morristown. I went through 3 different endos before I found him. He really listens when you have concerns and will go so far as to discuss journal articles with you if you have done your own research. And speaks to you like a peer. We had a long discussion about the benefits of natural thyroid replacement (pig thyroid) vs synthetic. And when my thyroid levels were good but I still felt off, he agreed to bump my dosage up, which made all the difference. He also recently diagnosed my sister's thyroid cancer and has been following her since surgery. A really great doctor. Again, he's not holistic, but very grounded in research and I don't think he would push back on trying natural treatments that are anecdotally effective, in addition to standard tx options. Not exactly easy to schedule with, but not insane. Accepts insurance.

jersey 123 & mums, Dr. Sanjay Kinkhabwala was mine as well. The best thing about him was he ran absolutely on time. Also, he dealt with my anxious, hyperthyroid induced questions quite well. And under his care I went back down to a normal baseline and no longer need to go (fingers crossed).

Wow. On time. If only....

@drummerboy type II diabetes isn't a one-size-fits-all condition and people often vary in how they react to different treatments.

Not to mention there are even different types of insulin. More than a lot of other conditions, patients and their medical professionals need to partner up to find the healthiest approach for them personally.

Personally there's no way I'd continue with a doctor who didn't understand a condition well enough to explain it or why they were taking one approach and not another...

Scully is right about the difficulties with a condition like diabetes. As for type II diabetes, that develops over time in adults with some variations but one of the hallmarks is that the patient no longer responds very well to their own insulin ('insulin resistance') even when their blood sugar is high and insulin release is appropriate. Giving more insulin as an injection makes little sense in those cases. Plus, the consequences of insulin resistance and all the stuff that caused it in the first place are too complex to try to post here all with my phone.

Trying to correct all that requires a comprehensive approach that many standard medical doctors just don't do. Hence, the endocrinologist is called upon. Again, the practitioner's approach is important even with a qualified specialist. I will say this though, expect to have your treatment involve all sorts of things in your life if it is going to be effective.

Oddly enough, particularly in spite of my own medical education and thus ingrained biases, my 'just about full on' type II DM was diagnosed and successfully treated by a chiropractor in Chicagoland. No medicines involved but I dropped over 50 pounds down to 170 and my HgA1c went from the 7's to the 4's in 6 months. Sound great but I did hate his guys for the first 3 weeks until the sugar withdrawal didn't bother me so much. And no, it wasn't because I started biking. I had been an avid cyclist for the past 10 years. I just sucked because I was heavy and always bonked a lot because my blood sugar was not controlled.

Finding the right person is such a crapshoot. Good luck finding your person. If you cannot find someone who accepts your plan, do you at least get some out of network coverage?

@drummerboy: What was arrogant was that Dr. Toscano wanted to prescribe insulin but she never tested my actual insulin levels and only did so at my insistence. When the results came back, they showed I have very high levels of insulin already. And then she says that doesn't matter! Bye bye!

Yes, Dr. Advani's staff leaves much to be desired. This last go-around I had to call 5 times to get the scrip for my blood tests (which they neglected to give me the last time I had been there). 4 times I never got it, and the 5th time I got it they gave me the wrong scrip (it's a good thing I know a thing or two about my health situations to realize it was someone else's scrip that they wrote my name on).

@bikefixed: I PMd you (TMI to post here!)

Yes, I have out of network coverage but I just cannot afford $500/per visit when insurance only deems $125 per visit a "normal cost" and then I get 80% of that. It totally wipes out my flex spend account.

The reason I raise the point is that I have Type II that is not well controlled, I produce insulin up the yin yang, and at this point the only thing that seems to be effective is more insulin (I mean a lot more - U-500 super concentrate). The extra insulin is meant to overwhelm the body's insulin resistance.

drummerboy said:

The reason I raise the point is that I have Type II that is not well controlled, I produce insulin up the yin yang, and at this point the only thing that seems to be effective is more insulin (I mean a lot more - U-500 super concentrate). The extra insulin is meant to overwhelm the body's insulin resistance.

Wow that is certainly interesting. I'm glad it's working for you. I really need to speak with a doctor to fully explain all of these things to me (because, from what I've learned/researched, so much just isn't logical to me).

ETA: When I was first diagnosed, I immediately responded to the medication to the point where the doctor was shocked at my progress. He took me off the glimiperide and immediately my sugar levels soared higher than they were before. I've never been the same since.

drummerboy said:

The reason I raise the point is that I have Type II that is not well controlled, I produce insulin up the yin yang, and at this point the only thing that seems to be effective is more insulin (I mean a lot more - U-500 super concentrate). The extra insulin is meant to overwhelm the body's insulin resistance.

Yes. It's not ideal, but it is sometimes necessary. But the physician should be able to explain her thinking clearly and partner with the patient in decision-making. Writing a prescription doesn't cut it, though admittedly it's extremely common.

Honestly, primary care docs caring for people with complex chronic conditions really, really need to set up their practices so they have a team approach to care. The doc can't do everything (and probably doesn't want to do everything), but too often there is no one else in the office with the capacity to help. It's a huge shift to move to such a model of care, but I hope we start to see more of it.

That may be the last resort in the immediate term but it will also reinforce the insulin resistance more than it would typically develop with uncontrolled blood glucose. Plus, the injection isn't like the normal pattern of insulin secretion. Is this 'regular' insulin or a longer acting (such as lente) formulation?

The way out of this problem is a hard road but worth it if you can do it. Again, I know it is difficult so I'm not just blithely suggesting anyone can do it just by wanting it to be so.

Cross posted. I was referring to injected insulin as opposed to adjusting the practice model in doctors' offices.

I have seen Dr. Advani for several years, I have recommended her in the past- but I am switching doctors because her holistic/natural approach has become more primary than her medical treatment. I have had symptoms that have gone untreated because she keeps recommending herbs, supplements, etc. that aren't working and cost substantially. And when I told her that she basically told me that I'm cheap.

She did a lot of good for me initially, and she can be tough when needed which is part of the treatment of diabetics. But she is so immersed in her natural healing practices that she has parted ways with some very standard diabetic treatments. IMO. This may well work for many patients; it does not for me.

I agree about Advani. I see her for hypothyroidism, but she has started pushing the supplement she sells so much it makes me uncomfortable. She wanted me to stop taking a med prescribed by another specialist. This med has worked for years and I believe it is very important for my well being. One of the supplements she wanted me for to take can be very dangerous in combination with this med. I hate to change, but think it may be time.

I'd be curious to hear the names of these supplements the doctors in question are advocating. If they have a 'trade' name the actual ingredients would be helpful for discussion.

bikefixed said:

That may be the last resort in the immediate term but it will also reinforce the insulin resistance more than it would typically develop with uncontrolled blood glucose. Plus, the injection isn't like the normal pattern of insulin secretion. Is this 'regular' insulin or a longer acting (such as lente) formulation?

Not to mention the effect of insulin as a promoter of increased fat storage in adipose tissue, which is a common problem for many (though not all) Type II people.

For me, she prescribed Alamax CR 600 mg. and something else I don't remember the name of (I stopped taking that after the first month because I couldn't buy it anywhere but her office and she was never open when I'm in NJ so I could pick some up).

I'm sorry @W.F. Call, but I howled when you said she called you "cheap". I can just picture it, and, frankly if she ever said anything like that to me, I'd laugh out loud in her face and walk out!

Okay. I call some very serious bull ***** on this doc. Allicin (garlic extract) has not been conclusively shown to have any beneficial effect in patients with type II diabetes.

I did find this study from the NIH, http://www.ncbi.nlm.nih.gov/pubmed/1204765, but it cites its use along with an oral diabetes drug called tolbutamide in treating an animal model of Type I diabetes. That is really a different mode of diabetes from Type II. Type I results from a destruction of the beta cells in the pancreas (these produce insulin and are the only functional source of endogenous insulin). Type II is a condition that develops over a long time of poor blood sugar control (for whatever reason) in spite of a fully functioning pancreas.

bikefixed said:

Okay. I call some very serious bull ***** on this doc.

Fully agree with this statement.

She's trying to sell things for her own monetary benefit. It's a load of BS. Horrible.

bikefixed said:

Okay. I call some very serious bull ***** on this doc. Allicin (garlic extract) has not been conclusively shown to have any beneficial effect in patients with type II diabetes.

I did find this study from the NIH, http://www.ncbi.nlm.nih.gov/pubmed/1204765, but it cites its use along with an oral diabetes drug called tolbutamide in treating an animal model of Type I diabetes. That is really a different mode of diabetes from Type II. Type I results from a destruction of the beta cells in the pancreas (these produce insulin and are the only functional source of endogenous insulin). Type II is a condition that develops over a long time of poor blood sugar control (for whatever reason) in spite of a fully functioning pancreas.

Alamax isn't garlic extract. It's alpha lipoic acid and biotin (which I take normally): https://www.xymogen.com/products/product-detail/11/ALAmax%20CR%E2%84%A2

Gosh, bikefixed, I've learned more from you about Type II Diabetes than I have from all the doctors I've seen over the last 4 years!

Okay. My bad in that Imistakenly selected Allimax in the list of auto-fill items when I searched for Alamax. I'm not all that coordinated these days. The stuff I said about Allimax is still relevant to diabetes, by the way. If anything be careful to make sure you are talking about the product you intend to refer to. The two products have identical sounding names.