Diabetes

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Keeping your blood sugar within target ranges will help prevent or delay serious health problems associated with diabetes. If you have type 1 diabetes, you will need medications and/or insulin therapy to keep blood sugars in check. Some people with type 2 can manage their diabetes without insulin through diet and exercise, although it's not unusual to eventually require medication or insulin.

Our endocrinologists can develop a treatment plan for you based on your type of diabetes and body’s insulin needs. Our certified diabetes educators and registered dietitians provide ongoing support through individual in-person or virtual sessions. Our goal is to empower you to control your diabetes with confidence and reduce your risk for chronic conditions that can result when diabetes is left untreated.

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Testing for Diabetes

If you have a family history of diabetes or experience symptoms like severe fatigue, consistent dehydration (increased thirst and urination), or numbness in your hands or feet, testing may be needed to diagnose diabetes or determine your risk of developing it. Results can often be determined during a visit to one of our clinics. Complex or challenging cases are referred to a clinic that specializes in endocrine disorders.

Blood Sugar Test

We may use a point-of-care glucometer to test blood sugar levels with a finger prick in clinic. If more information is needed, we’ll draw blood -- which may include fasting -- to measure your blood glucose levels.

Glycated Hemoglobin (A1C) Test

This blood test measures your average blood sugar for the past two-to-three months. It does not require fasting.

Tests If You Are Diagnosed with Diabetes

Your primary care provider will help you manage your diabetes but may also refer you to an endocrinologist for specialized care. This can be helpful if your cholesterol or blood pressure shows significant changes or you need to be prescribed new medication to manage your diabetes or its side effects.

Blood and Urine Tests

These annual tests may be requested by our endocrinologists to uncover changes in your body that could be affected by blood sugar and proteins. They can help determine if you would benefit from new or different medications.

Continuous Glucose Monitor (CGM)

This ongoing testing system includes small sensors inserted under your skin to record blood sugar levels each day. These readings are not continuous and our providers can't see information without your permission. Depending on the testing system you choose, information may be saved with an app or other technology so you can easily review results.

Some continuous glucose monitors can beep to alert you if your blood sugar is too low or high. The real-time results help you make dietary choices throughout the day, and you don’t have to perform as many daily finger pricks to monitor your blood. The data gathered also shows patterns in your daily blood glucose.

Our certified diabetes educators teach you to use continuous glucose monitors and can review results with you during an appointment to make adjustments to medications.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Insulin Therapies for Diabetes

Insulin therapy is necessary for people with type 1 diabetes to replace the insulin your body can’t produce. Some people with type 2 diabetes may also need this treatment. We help you choose an option based on your needs and what makes you most comfortable. Our nurses, physician assistants, and certified diabetes educators teach you to use syringes, pens, or pumps for your insulin therapy.

Concentrated Insulin

People with type 2 diabetes may have an insulin resistance that requires concentrated insulin, which is given in smaller doses. Our doctors specialize in treating people who require concentrated insulins. They offer the advantage of fewer doses and better absorption if you need regular, large volumes of insulin tailored to your body type and physiology. You’ll be shown how to dispense this medication on your own with insulin pens.

Some people with type 2 diabetes may have more severe insulin resistance that requires concentrated insulin, which gives more insulin in smaller volumes. Our doctors specialize in treating people who require concentrated insulins. They offer the advantage of fewer doses and better absorption if you need regular, large volumes of insulin tailored to your body type and physiology. A diabetes educator will show you how to dispense this medication, which can be available in special vial and syringes and insulin pens.

Call for an Appointment

855-855-6484

Non-Insulin Therapies for Type 2 Diabetes

No matter what kind of diabetes you have, following a diet and exercise plan can help you feel better. We offer comprehensive group classes and one-on-one instruction to teach you about nutrition and how to stay active. Your care team may suggest additional ways to manage diabetes and its symptoms without insulin.

Medication

Our providers specialize in newer oral and injectable non-insulin therapies that maintain safe blood sugar levels and help with weight loss by regulating your appetite. Many of these medications can also prevent kidney and heart complications. Depending on the severity of your symptoms, your doctor will show you how to safely take these medications at home on a daily or weekly basis.

Weight Loss Surgery

If you have type 2 diabetes and weight loss programs and medications have not been effective for managing your weight, you may want to consider bariatric surgery. For some people, the physiological changes from the surgery combined with weight loss and changes in diet following surgery may improve their diabetes. Your doctor will work closely with your surgery team to ensure the best outcome. Nutritional and behavioral health guidance is part of your surgery and recovery.

Best Hospital for Endocrinology and Diabetes in NC

When it comes to your care, you want the very best. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our diabetes and endocrinology program is the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Resources to Help You Manage Diabetes

Duke provides a variety of ways to help you improve your quality of life with diabetes. Along with free online resources, in-person and virtual diabetes education classes are typically covered by insurance, Medicare, and Medicaid.

Adult Diabetes Education Program
Our certified diabetes educators run virtual group classes that focus on all aspects of diabetes management, including learning about pre-diabetes and gestational diabetes, insulin pump therapy, continuous glucose monitoring, and carbohydrate counting. You can also learn more about these topics in individual sessions with our certified diabetes educators. A referral from your provider is required to make an appointment for this program.

Diabetes Education and Nutrition Counseling Program
Certified diabetes educators and dietitians teach you about a range of topics related to diabetes, from how it affects your body to lifestyle management. Learn how to plan meals, deal with emotional challenges, exercise effectively, and more. A referral is required, so ask your provider about enrollment opportunities.

Health Education Library
A collection of Duke-approved videos and other materials can offer answers to many of your questions about diabetes and its impact on your life. It’s free to use and can also be accessed on the My Duke Health app.

Risk Assessment for Diabetes Complications
Complications from diabetes can include heart, kidney, and nerve conditions. We can refer you to specialists as needed and work closely with them to help you manage your diabetes and the chronic conditions that can result.

Work with Exercise Experts
The Duke Health & Fitness Center offers appointments with exercise physiologists through its Diabetes Exercise Program. The consultation can provide you with the knowledge and confidence to set goals and create a safe and effective exercise plan. The meeting can take place in person or virtually, and any recommendations will be documented in your My Duke Health (previously Duke MyChart) account so your Duke Health providers can be a part of your care team.

This page was medically reviewed on 01/28/2022 by

Jennifer V. Rowell, MD | Endocrinologist