The need for more diabetes specialists

(Conclusion)

The alarm has been sounded since the turn of the century. The rising rates of diabetes worldwide, especially in Southeast Asia, including the Philippines, need urgent action and preparation. To say that diabetes has reached epidemic proportions is not an overstatement.

We have so many factors to blame, but the increasingly westernized lifestyle which we have unapologetically adopted is definitely a major factor. One only needs to watch an hour of television, and taking careful note of the commercials, to realize how dramatically our dietary patterns and preferences have changed.

Stay strong

With diabetes, of course, comes a litany of related medical problems and complications. And that’s where the “sad story” about the epidemic of diabetes in “Third World” or developing countries like the Philippines start. As a noted diabetes expert once commented, “hunger and poverty coexisted with diseases from the affluent West, but without a western-standard health system.”

Considering the big number of diabetics and the foreseeable doubling of this number in the next 10 to 15 years, it’s mathematically impossible to come up with enough number of certified endocrinologists to meet the increasing demand since the certifying body—the Philippine Society of Endocrinology, Diabetes and Metabolism (PSEDM)—is currently able to add only around 30 new specialists annually to its roster. Add that to the current 225 diplomates or certified specialists (a good number of whom are already in the retirement age), and the country would likely have a specialist force of around 500 in 10 years. With more than 10 million diabetics, prediabetics and people at high risk to develop diabetes by that time, the patient-specialist mismatch would really be expected to get worse.

Our endocrinologists really need all the help they can get in terms of adequate treatment of existing diabetics and prediabetics, and preventing people at risk from developing this metabolic condition. Likewise, existing diabetics must be prevented from developing the dreaded complications of the disease.

United front

The endocrinologists need to lead a united, not fragmented, front of medical practitioners who can help look after the millions of Filipinos who have diabetes and related problems.

PSEDM can forge some alliance with the Institute for Studies on Diabetes Foundation (ISDF), Diabetes Philippines, the Philippine Society of Diabetologists and other medical organizations, equipping its members on the latest trends in the management of diabetes. I’m sure they can harmoniously resolve whatever issues they have and rally together on how to stem the tide of diabetes and the disabling and potentially fatal complications it causes.

PSEDM must also welcome the support of other societies and organizations composed of nonmedical healthcare professionals in educating the public on how the problem and its complications could be prevented. Notable among these is the Philippine Center for Diabetes Education Foundation headed by Dr. Augusto Litonjua.

Fighting diabetes

Dr. Litonjua is one of the pioneers who established the specialty of endocrinology in the country. In 1961, fresh from his training in the United States, he brought together 16 other doctors interested in the teaching, practice and research of endocrinology and metabolism; and founded what was known as the Philippine Society of Endocrinology and Metabolism (PSEM). It was only recently when the officers of the society decided to rename it as PSEDM to highlight their focus, which is to curb the imminent epidemic of diabetes in the country and worldwide.

A few years after founding PSEM, Dr. Litonjua also established the first fellowship training program in endocrinology, diabetes and metabolism in the country, at the University of the Philippines-Philippine General Hospital.

Although he can already retire, relax and be content at the thought that he has done his part well in making sure there are adequately trained endocrinologists in key cities of the country, Dr. Litonjua still feels uneasy doing that because he knows fully well that Filipinos have joined the global bandwagon in adopting unhealthy lifestyle practices that predispose them to develop diabetes and related problems.

Another icon in the fight against diabetes is Dr. Ricardo Fernando. He has mentored legions of practicing physicians in the management of diabetes, all of whom calling him “Tatay.”

He founded both the Institute for Studies on Diabetes Foundation (ISDF) and the Philippine Society of Diabetologists Inc. A true visionary who anticipated the big gap of trained physicians treating diabetics more than 20 years ago, he has really championed the improvement of diabetes management and care as evidenced by a steady stream of graduates in ISDF’s diabetology master’s degree courses.

Just like the PSEDM members, the ISDF graduates “pay forward” by generously sharing what they have learned from the institute, with medical colleagues practicing in the provinces and through the various training workshops they conduct year round.

We need more Dr. Litonjuas and Dr. Fernandos to rise from the ranks of our younger specialists in diabetes care.