Portage lacks diabetes doctors

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The U.S. Centers for Disease Control and Prevention estimates 24 million Americans have some form of diabetes, a disease that affects the body's ability to regulate and process sugar.

An estimated 500,000 of them live in Northeastern Ohio. Of those, an estimated 11,000 were Portage County residents affected by either Type I or Type II diabetes in 2005, the last year of available data from the CDC's National Diabetes Surveillance System.

Doctors specializing in diabetes care are called endocrinologists. But of the 70,000 to 80,000 endocrinologists practicing in the country today, not a single one has a practice in Portage County.

Endocrinologists are in high demand, and getting the minimum of two needed to serve Portage County would be difficult, according to Robinson Memorial Hospital spokeswoman Jennifer Farquhar.

The number of practicing endocrinologists currently is 12 to 15 percent below the number needed to handle the demand for patient care, according to the American Association of Clinical Endocrinologists. The shortage will be twice as bad by 2020.

"The shortage is a nationwide problem and it's hard to recruit for rural areas like Portage County," Farquhar said. "We have been seeking them out, but we've been unlucky so far. They tend to gather in urban areas like Akron or Cleveland, get an office and share coverage."

Clint Snyder, associate dean of medical education at the Northeastern Ohio Universities Colleges of Medicine and Pharmacy in Rootstown, said endocrinology and diabetes are in the basic science lessons for NEOUCOM's first year students.

But new doctors aren't simply dubbed "endocrinologists" upon graduation, Snyder explained. Once out of medical school, they complete a three-year residency in internal medicine and can then opt for additional training in the specialty, he said.

"Robinson Memorial doesn't have that residency training program, but with them now affiliated with Summa Health Systems, it could potentially give us an avenue to get more residency trainees" in Portage County, Snyder said.

Of 2,572 alumni in NEOUCOM's alumni database, 402 list internal medicine as their specialty, according to Snyder. Fifteen of those have stated they have completed training in endocrinology, but the number could be higher.

"These (15) are the only ones that have updated their information with us to report endocrinology as their specialty," Snyder said.

One step Robinson Memorial took in response to the shortage of doctors and increased numbers of diabetes patients was to create a Diabetes Care and Education Center at its Kent Medical Arts building. Three American Diabetes Association-certified diabetes educators, including registered nurse Ed Eichler, staff the center and provide information to newly diagnosed patients, most of them adults.

Eichler said in the past 11 and a half years, he's seen more and more new patients each year. He said he expects to see between 400 and 450 patients by the end of 2008.

"It's an epidemic, especially in Type II diabetes. I was at a program not long ago and saw some data on percentages, and they're really increasing," Eichler said. "It's kind of scary."

A planned community health clinic, a partnership of Robinson Memorial, Portage County government and other county agencies planned for Kent's east side would be a federally-qualified health center for uninsured or underinsured residents and "won't include specialty practices" such as endocrinology, Farquhar said.

Doctors tend to stay close to their place of family origin and tend to remain in the place where they do their residency, which is why NEOUCOM tries to recruit students from Northeastern Ohio, Snyder said.

Luckily, "there seems to be a more positive trend that we're (diagnosing diabetes) sooner than we used to" thanks to the efforts of primary care physicians, he said.

Until more endocrinologists can be found to Eichler said the old adage "'An ounce of prevention is worth a pound of cure'" is the ticket to controlling diabetes and its complications.

The two most prevalent types of diabetes are known as Type I and Type II. Type I diabetes occurs when the body's immune system destroys the cells in the pancreas that produce insulin, the hormone that regulates blood sugar. Type II diabetes occurs when the body loses its ability to produce insulin, usually due to risk factors including obesity, heart attack or stroke.

"The good news I like to share is that a dozen years or so ago, some medical studies were completed that showed us for the first time that we can prevent complications" from diabetes, Eichler said. "The people that work in certified diabetes education, we teach people about the same sort of thing they're teaching all over the country."

Robinson Memorial's Diabetes Care and Education Center can be reached at 330-677-1552, he said.