Greensburg Daily News, Greensburg, IN

July 24, 2013

New physician adds specialty expertise to DCMH diabetes care

By Rob Cox Daily News
Greensburg Daily News

---- — GREENSBURG – In 1992, there were 6.2 million diabetics in the United States; in 2013, that number has ballooned to 26.5 million.

Decatur County Memorial Hospital (DCMH) Endocrinologist Dr. Shahab Zaidi, MD F.A.C.E. offered those startling numbers last week when he sat down with the Daily News to introduce himself to the community.

Zaidi’s first day at DCMH was June 26.

He joins DCMH following 19 years of practice in Indianapolis where he worked in endocrinology at St. Vincent’s Hospital. He was also chairman of the Hospital’s Division of Endocrinology, Diabetes, and Metabolism for two years.

Originally from Karachi, Pakistan, Zaidi first came to the United States in 1984. He’d already earned his medical degree and had completed an internship in his home country when he decided to continue his training here.

“America is the promised land,” he said. “In Pakistan, there was a limit as to how much I could grow and advance as a doctor. To expand your horizons, you had to go elsewhere. Post-graduate medical training simply isn’t available where I grew up. This country gave me the opportunity to grow both intellectually and financially. I owe everything to this country.”

Once in the United States, Zaidi would spend five years in Michigan completing his medical training at both Hurley Medical Center in Flint and the Wayne State University School of Medicine. He finished in 1992.

Endocrinology, Zaidi explained, deals with any kind of hormonal disorder. As such, in addition to his diabetes-related work, Zaidi also treats patients for obesity, hypo- and hyperthyroidism, dyslipidemia, hypertension, adrenal disorders, metabolic bone disease and osteoporosis, and pituitary disorders.

As with the field of Endocrinology itself, however, Zaidi’s session with the Daily News was dominated by diabetes.

“Diabetes is the bread and butter of any endocrinology practice,” he said. “Unless you’re in a practice with a research-intensive focus or, sometimes, at a teaching hospital, the treatment of diabetes will be a major focus.”

The pancreas, he explained, is one of the body’s major endocrine organs. It secrets a hormone called insulin, which is critical in helping the body regulate and break down sugars and carbohydrates. The pancreas’ inability to secrete insulin or to secrete sufficient amounts leads to diabetes.

Zaidi has steadily tracked the aforementioned diabetes statistics for decades. The numbers themselves, he said, don’t tell the whole story of diabetes in the United States. “For every two patients diagnosed with diabetes,” he said, “there’s one who isn’t diagnosed. It’s an epidemic with no competitors.”

By 2050, he added, the number of diabetics in the United States is projected to increase to 88 million.

And those numbers don’t take into account the number of patients with “impaired glucose tolerance,” which is basically a pre-diabetic stage wherein the body does not break down glucose as efficiently as a normal, healthy individual. Patients with impaired glucose tolerance are teetering on the edge of full-blown diabetes.

“There are 79 million people in the United States with impaired glucose tolerance,” Zaidi said, adding that these patients, unlike diabetics, tend to be asymptomatic.

Exacerbating the problem, the number of Endocrinologists in the United States is startlingly low.

“Of 300 million people in the United States,” Zaidi said, “there are 4,000 endocrinologists. They are very expensive to train.”

As a result, only 5.9 percent of all diabetic prescriptions written in the United States each year are written by endocrinologists, meaning that dealing with and treating the disease is largely left up to primary care physicians (PCP).

“The PCP is the gatekeeper,” Zaidi said. “They must be effective listeners.”

As a doctor, Zaidi said it’s not hard to understand the reasons for the diabetes epidemic in this country.

“We exercise less,” he said, “and we eat food we shouldn’t eat.”

A family vacation last summer to Malaysia, Singapore, Thailand and China, Zaidi said, provided a stark reminder of the reasons behind America’s diabetes epidemic.

“Everywhere we went,” he said, “one of the most astounding things we saw was that people were thinner, with much smaller BMIs (Body Mass Index). The portion sizes were so much smaller.”

He continued, “In this country, 35 to 40 percent of the population is overweight and 33 percent are considered obese.”

Diet – including the types of foods consumed and the amounts – lack of exercise and too much body fat are all critical factor in the development of diabetes, according to Zaidi. He cited a study which found that patients who made intensive lifestyle adjustments to their diets and exercise habits more effectively lowered their risk of developing diabetes than patients who took a common diabetes drug.

“For every 500 calories you burn through exercise,” Zaidi said, “you decrease your risk of developing diabetes by six percent.”

He stressed, however, that any exercise routine must be combined with a low-calorie diet for maximum benefit.

Reducing one’s risk of developing diabetes is well worth the effort, Zaidi said, as diabetics face an increased risk for a whole range of health problems. Diabetics, for instance, have a risk for developing heart disease that’s two-to-four times greater than that of the general public. Their risk for suffering a stroke is five-to-six times greater, while they have a risk for peripheral vascular disease that’s seven-to-eight times greater compared to the general population.

Most strikingly, according to Zaidi, 90 percent of all diabetics die of heart disease or cardiovascular complications.

Diabetics are also at an increased risk for problems with their feet, including non-healing ulcers that can lead to the need for amputations. As a result, Zaidi works closely with the DCMH Wound Care Clinic in treating many of his patients, engaging in what he called a “multi-disciplinary approach” to care.

Prevention of diabetes and stemming its growing epidemic, Zaidi said, is a “process of educating our patients. I tell my patients to set a goal of 150 minutes of cardiovascular exercise a week. You also have to start at elementary, junior high school and high school. You have to start incorporating healthy eating habits among those age groups and exercise regimens.”

Contact: Rob Cox 812-663-3111 x7011