2Challenge – Prevention
DIABETES: Diabetes is the third leading killer of mankind, following heart disease and cancer. (Also, it is a major causative factor for the first leading killer ie., heart disease.) If improperly managed, diabetes devastates multiple organ systems of the body [heart, feet, kidneys, eyes, nerves, brain, etc] necessitating comprehensive and scientific, medical and public health management. This becomes particularly important in the Indian context, since Indians [both native and migrant] have very high predisposition to diabetes. Thus, India currently has the largest burden of diabetes than any other nation in the world, and the situation is expected to worsen in the years ahead. It is projected that by year 2010 there will be about 52 million people with diabetes in India alone.
ENDOCRINOLOGY – METABOLISM: [The medical discipline dealing with disorders of body’s chemistry, hormones etc.; stated in very simple terms]. This is a relatively young medical superspeciality, which is in an early state of development in India. Yet human disorders which come under this discipline constitute a major cause or contributor to human suffering and death throughout the world. Diabetes being the number one endocrine metabolism disorder, others include disorders of thyroid, growth and development, fertility and reproduction, obesity and lipids, atherosclerosis, bone-mineral etc.
DYSLIPIDEMIA, ATHEROSCLEROSIS AND HEART DISEASE: While evaluating the importance of the superspeciality of Endocrinology – Metabolism, we need to realize that the root cause of ATHEROSCLEROSIS [blockage of blood vessels by cholesterol/ fats] and HEART ATTACKS, is yet another metabolic disorder called DYSLIPIDEMIA [abnormal blood fats – cholesterol and triglycerides]. Like diabetes, dyslipidemia needs very comprehensive and scientific, medical and public health management [in an aggressive – WAR FOOTING], to reduce and prevent human suffering and death from major vascular diseases like heart attacks, strokes, gangrene etc.
PREVENTION: Finally, it is obvious that the primary emphasis of “DIABETOLOGY- ENDOCRINOLOGY – METABOLISM” is PREVENTIVE in nature, rather than CURATIVE/ REPAIR [as with Cardiology – coronary angioplasty, heart bypass surgery; or Nephrology – dialysis, kidney transplantation etc.,]. Herein lies the long term public health importance of the relatively sober [less “glamorous”] medical superspeciality of ENDOCRINOLOGY – DIABETES – METABOLISM, with its potential to be a major contributor to the quality and quantity of human life in the years ahead [particularly preventive and health promotional aspects].