LUCY SCHULTZE

Physicians are getting involved in today’s diabetes epidemic through ways more than just treating patients.

Dr. Jayant Dey of Metabolic Disorders Institute in Tupelo says it’s important for physicians to be in contact with local officials and state legislators as part of efforts to facilitate healthier communities.

“The solution to the epidemic we are seeing is not going to come out of doctors’ offices,” he said. “It will have to come out of the society itself. People in places where they make decisions will need to be involved in order to make changes and begin to make a dent in this problem.”

Research and conversations within the field of diabetic treatment point to communitywide public health initiatives as faring best against obesity and its causes, Dey said. Among the changes physicians can encourage in their communities are mandates for sidewalks in new developments, as well as mixed-use urban building patterns that make it easier for people to walk from home to the grocery store or other destinations.

Something as simple as providing safe environments for children to go outside and play can make a big difference, Dey said.

“Those are the kinds of things that have significantly impacted places like inner-city New York,” he said. “It has helped get the weight problem down to some extent.”

In Mississippi, though, the outlook is increasingly bleak. The state earned the dubious distinction this year of becoming the first to cross the 30-percent mark for obesity. About one in 10 Mississippians live with diabetes, and the Mississippi Diabetes Foundation estimates one in three children will develop the disease in their lifetime.

Although Mississippi ranks highest, much of the nation isn’t far behind. Beyond American borders, the global rise of obesity and diabetes is one Dey can track both professionally and personally.

Each visit to his hometown of New Delhi illustrates how India’s booming economy is taking its toll on public health, as convenience cuts back on the need for physical activity. When he was there six months ago, he was struck by how streets previously full of workers commuting by bicycle are now clogged with motor vehicles.

“Compared to what I used to see even 10 years ago, I was astounded,” he said.

“In some ways, countries like India and China are going through now what we went through 25 or 30 years ago,” he said. “But our transition was much slower than theirs seems to be.”
Nevertheless, he said, it’s encouraging that the variety of drugs and devices used to treat diabetes continues to broaden, making for a more tailored approach.

“The very fact that we have a wider choice to make a regimen for our patients allows us a lot more flexibility than we ever had in the past,” he said. “It allows us to have medicines which will suit a person just right, rather than throwing one medicine to all people with all their different problems.”

Both the introduction of newer and better insulin drugs and of devices which provide ongoing monitoring of blood-sugar levels are providing better control with fewer risks for patients. While the new aids to treatment help Mississippi’s growing diabetic population live with the disease and stem complications, physicians like Dey hope that taking a more activist approach in their communities will eventually help turn the tide.

“It is frustrating, because by the time these patients make it to us, most of the damage has already been done,” he said. “We’re just fighting fires rather than trying to prevent them.”


November 2007