Q&A: ADA’s Outstanding Educator sees life in a tennis match
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SAN DIEGO — A match of tennis, with its divisions of points, games and sets, is “reflective of life in many ways,” in the view of A. Enrique Caballero, MD, who said he found a new passion in the game after playing soccer for many years.
“You play with what you have, trying to capitalize on your own strengths. You have mistakes, but there’s always the opportunity to correct them, forget about the past and try to do the best in that next point,” Caballero said of the sport, adding that, like life, whether you win or not is less important than “knowing that you’re manifesting all your attributes, that you are doing your best, and that you are better today than yesterday.”
Caballero, associate professor of medicine at Harvard Medical School, has been honored with this year’s Outstanding Educator in Diabetes Award from the American Diabetes Association. Over more than 25 years, he has taught a wide variety of courses on diabetes for patients, families and health care providers in close to 100 countries around the world and has worked extensively to reveal how diabetes affects members of underrepresented racial and ethnic groups, particularly Latino/Hispanic communities.
In an interview with Healio, Caballero discussed his outlook on improving diabetes care for everyone, regardless of where they happen to be in the world, his deep admiration for his parents and life beyond endocrinology.
Healio: What are you like outside of your job? What interests you beyond endocrinology?
Caballero: I’m originally from Mexico City. That’s where I was born, and I grew up in a modest but nice household where my parents created a stimulating and loving environment for my sister and me. My parents were schoolteachers and strongly believed in nurturing your inner self, your body and your mind. I have tried to follow this important mission in my own life. My wife, who’s also originally from Mexico, and I have four daughters, all of them born here in the U.S. I enjoy dedicating a lot of my time to my family. I am privileged by being surrounded by wonderful and amazing people. Seeing how each of our daughters is doing so well is truly a blessing.
I also like to implement a healthy lifestyle. I like to exercise, and I play tennis. That’s been my passion for years. You can imagine I played soccer — fútbol — when I was young, as probably almost everybody else in Latin America did. And then as I got older, I couldn't play anymore, so I transitioned to playing tennis, which I’ve been playing for the last 25 years or so. I do that regularly, and I love it. I also like to read non-medicine topics and play dominoes. It is a whole intellectual challenge to play it at a high level.
But it is not and should not be only about me. I always look for the opportunity to help people out there, and there’s many ways to do it. Life gives us the opportunity to always help others — whether that’s your neighbors, your friends or maybe people that you don’t even know — with very small tasks and things that may be considered trivial. But I grew up with the idea, which I learned from my parents and continue to implement up to this point, that to call it a successful day you need to combine two things. One is to learn something, and the other is to do something good for someone else. If you do that every day of your life, you have plenty of reasons to feel well and satisfied and that you’re growing and probably living the best version of who you are. So that keeps me busy, but it’s obviously a nice way of being busy.
Healio: Who is someone who you admire, and what would you ask if you had 5 minutes with them?
Caballero: There are a lot of wonderful people that I’d like to meet. But I would just love to have 5 minutes with my parents again, who are no longer around, because I learned so much from them and feel that I still owe them so much. Now that I have my own family and my own daughters, who are now older — the oldest is 26, and the youngest is 15 — I would ask my parents, “Did you ever imagine that so much of what you taught me would have such an impact in future generations?” They have definitely contributed to this legacy effect. Now, they’re not around to see it, but I am sure that they would probably be very proud of seeing what has happened. However, I would still ask for any further advice on how to keep moving.
I have been grateful to have wonderful parents. I have admired them, and I still hear and listen to their voices somehow. So, I would love 5 minutes, of course. Even 1 minute would be wonderful.
Healio: What was the last book you read, and what did you think of it?
Caballero: The last one that I read was called La Catedral del Mar – “The Cathedral of the Sea.” It’s a Spanish book from Ildefonso Falcones. It talks about medieval times in Barcelona, when one of the most important cathedrals was built. It’s the whole story about how it was built and the faith that everybody in that community had to create something, in that case for Santa Maria del Mar. It’s a beautiful novel. I really loved it. It’s really very nice because it talks about the human spirit and how collectively you can create a lot of wonderful things.
Healio: What area of research in endocrinology interests you the most right now, and why?
Caballero: The implementation of science in different communities around the world is an area that has been of strong interest to me for quite some time. We are living in the best time in history for diabetes care in terms of scientific advances, pharmacological therapies and technology. We now have continuous glucose monitors, better medications, insulin pumps. We have a lot more knowledge about many different things. But the reality is that despite all these benefits, most people with diabetes are not achieving basic treatment targets. We have a lot of knowledge and science, but we are not helping people effectively.
I think that the future, and what I would like to see happening, is to identify solid strategies that would allow everyone to benefit from all these great discoveries, medications and technologies that have been developed in the last few years. We are not there yet. And there are huge political, social and economic challenges, but that’s what I would like to see: more support to conduct research in that area to demonstrate effective strategies to reach everyone and offer optimal care to all people living with diabetes around the world. I think that would be awesome.
Healio: What do you think is going to have the greatest influence on your field over the next 10 years?
Caballero: I would say the application of current technologies in routine clinical practice, and designing strategies in which we could do remote assessment and guidance with patients, without the need to continue with the same traditional model of people coming to the clinic or the hospital just when they’re not feeling well or they’re sick. We need to transition from reactive to proactive models of health care. An approach that would really embrace the management of chronic diseases more effectively.
For example, I would not necessarily need to see a patient every 3 months for 15 minutes and that’s it, but maybe have more regular contact with patients when they’re at home — reviewing the results of their blood sugars, their blood pressure, some metrics, discussing things in order to help them — and not only to see them when they’re not doing well, which is honestly what’s happening in many cases in the current system. I think that in 10 years from now we should really have better ways to provide care that is home-based, that is community-based, and not just hospital-based. These new models of care could capitalize on the great advantages of telemedicine and remote consultations. Of course, we also need to ensure that all individuals have access to all digital tools.
Healio: Have you ever witnessed health care history in the making?
Caballero: I would talk about my involvement in the Diabetes Prevention Program. I’ve been a co-investigator in this unique research study since its inception. Some of the first results were published approximately 20 years ago. We demonstrated that type 2 diabetes can be prevented, or at least delayed. Type 2 diabetes is nowadays one of the most common diseases around the world, and a landmark finding was the fact that you can prevent type 2 diabetes, even if you already have prediabetes and other risk factors such as a strong family history of the disease, by improving lifestyle — good nutrition, physical activity, losing some weight. That’s been one of the most important studies that have had public health implications.
Unfortunately, the sad part of the story is that even though some prevention programs have been implemented as a result of these findings, we don’t have enough of them to help the huge number of people with prediabetes in this country. And that’s one deficiency I see in the system, that there’s not a lot of emphasis on prevention. But clearly, I’ve been very fortunate to be part of a fantastic group of investigators that have really looked at early stages of diabetes and the importance of preventing the development of the disease, rather than waiting until the disease is there.
Reference:
- Extraordinary Leaders in Diabetes Research, Prevention, and Treatment to be Recognized at the ADA’s 83rd Scientific Sessions. https://diabetes.org/newsroom/press-releases/2023/extraordinary-leaders-diabetes-research-prevention-treatment-recognized-at-ada-83-scientific-sessions. Published March 14, 2023. Accessed June 5, 2023.
Caballero reports no relevant financial disclosures.