VIDEO: Primary care providers need to understand differences in type 2 diabetes treatments

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Well, I'll take a step back from that as well. And that is that the forces that have prompted this pandemic, this worldwide epidemic of Type 2 diabetes are not medical problems. I mean, they don't start out as medical problems. They start out as issues of having enough food. That populations can eat as much as they want, even though food is more expensive now than it was. I know that. But inexpensive low quality food in particular is abundant in our country and in much of the world. There are still places affected by famine, of course. But anyway, so on a kind of a societal level, we can all play a role in educating the population of the risks of gaining weight. And again, this is not to demonize people who are overweight or obese. And it increases the risk of getting diabetes by something like 60 to 100 fold. Not one time or twofold or threefold, but like almost 100 fold. So, I think that we all have the responsibility, primary care, endocrinologists, everyone, public health officials, to make certain that the population understands that. The second thing is that once it becomes medicalized, meaning that someone's developed, gone from pre-diabetes to diabetes, of course we need to have both the generalists, very few endocrinologists, diabetes experts, number of primary care specialists, including doctors, nurses, nurse practitioners is far greater. So, really starting to treat these folks has got to go back to primary care. And I think that they need to be aware of the differences in treatments that are available now as are the endocrinologists. But the primary care people cannot just be watching the television commercials. They really have to have a better understanding of when specific medications, for example, are called for. What kind of nutrition advice should be given and by whom? You know, what kind of activity level advice needs to be given? Population with type two diabetes is characteristically, used to be just old people. Well now, it's starting in youth, adolescents, and it's developing increasingly in younger people of thirties and forties. And they are actually able to exercise safely with not worrying about breaking a hip as much, as the older population. And they need to change their eating behaviors and activity behaviors quickly. And the people who used to have at least some persuasion, some ability to persuade people were their doctors. As strained as we are in terms of providing care to our patients, I think that some combination between primary care and specialists needs to occur.