The Missing Link in Treating Diabetes: Too Few Diabetologists

iStock

About one-third of Americans have prediabetes or type 2 diabetes and the emerging medical field of diabetology is designed to address this health care crisis. But the number of diabetologists — endocrinologists who sub-specialize in diabetes management — is dwindling in the United States, and primary care physicians currently treat about 82 percent of people with diabetes.

In 2004, one-year fellowship programs to give primary care doctors the skills to better manage diabetes and its complications were created. Now, 14 years later, research published in the Journal of the American Osteopathic Association suggests resistance in the health care industry may be impeding the growth of the diabetology field.

The researchers surveyed the 39 physicians who graduated from the first two fellowship programs, at Ohio University College of Osteopathic Medicine and East Carolina University Brody School of Medicine, between 2005 and 2016. Of these doctors, 41 percent work in primary care, 20 percent work as hospitalists, 14 percent are full-time diabetologists, and 22 percent continued their training to become endocrinologists. Only 28 percent of the doctors said they agree or strongly agree that colleagues are receptive to their diabetes training, and 19 percent disagree or strongly disagree. In addition, insurance companies are often reluctant to reimburse for a new sub-specialty that is mostly unrecognized, and most diabetologists are paid less because they typically see fewer patients. Board certification in diabetology may help remedy these issues in the future.

Sourced from: The Journal of the American Osteopathic Association