Type 2 Diabetes, Managed by Your Family Doctor.

Do I need an endocrinologist? For most people with type 2 diabetes, no. A board-certified family physician manages your medications, monitors your labs, screens for complications, and helps with the daily realities of eating and moving, all in one place. Endocrinologists are invaluable for type 1 diabetes, complicated insulin regimens, and unusual cases, and we refer when that is the right call.

What many patients want to escape is referral fatigue: a primary care visit, then an endocrinologist, then a dietitian, then a cardiologist, each with a different portal and none of them talking to each other. Here, one doctor holds the whole picture. Dr. Gougian knows your A1C history, your weight goals, your cholesterol, and what is going on in your life, because she is the one you see every time.

Metformin is still the usual first medication: safe, inexpensive, effective, and well understood. Many people do well on it for years.

GLP-1 medications changed the conversation. Ozempic (semaglutide) and Mounjaro (tirzepatide) are FDA-approved for type 2 diabetes and also produce meaningful weight loss, which in turn improves blood sugar, blood pressure, and cholesterol. Because Dr. Gougian is a Diplomate of the American Board of Obesity Medicine as well as a family physician, these medications are prescribed here by someone who understands both sides of what they do. Most plans require prior authorization for them; our office handles it.

SGLT2 inhibitors such as Jardiance and Farxiga lower blood sugar through the kidneys and have added benefits for the heart and kidneys. DPP-4 inhibitors, sulfonylureas, and insulin each have a role depending on the situation. The right combination depends on your numbers, your other conditions, your budget, and what you can realistically take every day.

• A1C every three to six months, drawn in our office so there is no separate lab trip.
• Fasting glucose and a lipid panel, since cholesterol and diabetes travel together.
• Kidney function: eGFR from your blood and albumin in your urine, at least yearly.
• Blood pressure at every visit.
• A foot check at visits and a yearly dilated eye exam, which we refer out for.

Chronic kidney disease deserves a specific mention. Diabetes is the leading cause of it, and it develops silently. Catching a rise in urine albumin early, and treating it with blood pressure control and medications like SGLT2 inhibitors, can slow or prevent its progression. That is why kidney labs are part of routine monitoring here, not an afterthought.

Diabetes doesn’t exist by itself. It travels with weight, high blood pressure, high cholesterol, fatty liver, and sleep apnea, and together they drive heart attack and stroke risk. Treating the blood sugar number while ignoring the rest is how people end up on six medications and no better off.

Dr. Gougian’s obesity medicine training means the whole metabolic system gets treated. That might mean a GLP-1 chosen for both blood sugar and weight, a statin when your risk calls for it, an honest look at food and sleep, and a metabolic health assessment to see where you stand. Physician-guided weight loss is available here with no subscription, and it is often the most powerful diabetes treatment there is.

Unhurried visits with the same doctor. Lab results explained in plain language, with the numbers that matter and why. Medication changes made together, not handed down. Prior authorization handled by our office. And follow-up that is easy to get, because diabetes care is a long relationship, not a series of appointments with strangers.

Medicare and Maryland Medicaid patients are welcome, along with most major plans and self-pay, and we tell you what a visit costs before you are seen.