Pedro Casado Escribano, new coordinator of the Diabetes, Obesity and Nutrition Working Group.
The XVI meeting of the Working Group on Diabetes, Obesity and Nutrition of the Spanish Society of Internal Medicine (SEMI) has had a successful attendance that denotes the high interest of Spanish doctors in these issues on the rise, both due to the boom in scientific knowledge and its growing prevalence among the population.
To analyze everything lived and the future of these pathologies, Medical Writing interview with the new coordinator of the Group, Pedro Casado Notary. The assistant to the Internal Medicine service of the University Hospital of the Princess (Madrid) assumes the position highlighting everything that has been achieved and willing that both diabetes and obesity obtain the importance according to the volume of patients who suffer from them.
The meeting has had a great success of participation. Are doctors very interested in diabetes and obesity or is it fashionable to take care of nutrition?
Both things happen and, in addition, we must add the good previous work of the Working Group. Since it was created, it has been a Group with very interesting and attractive potential for internists. We are in a time of very overwhelming knowledge and very powerful development of the pharmaceutical industry. All the incentives and elements are given so that there is this success of assistance and that there is a high scientific level.
Are doctors becoming more aware of diabetes and obesity?
I think so, but we still have a lot of work to do. Clearly, there is a pandemic concept that we are seeing of obesity and diabetes with increasing population figures. We are having better results in reducing events at a percentage level, but there is clearly a net increase in patients and we are becoming increasingly aware of the epidemiological situation in our environment.
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“We are in a time of very overwhelming knowledge and very powerful development of the farmain industry” |
What role should Internal play in these pathologies?
As fundamental as that of other colleagues. We are not more, nor should we underestimate what we do. It is true that we have a lot of weight at the hospital level because we discharge more diabetic patients than the rest of all the specialties combined. We see the patient from the beginning of the disease, and even in a pre-diabetes situation, until the end of its evolutionary stages. This is a very important aspect of our specialty and, for this reason, we have to carry out very generic training that covers the entire spectrum of the disease.
During the meeting, much emphasis was placed on the comprehensive approach. Do you consider that it is something fundamental to treat diabetes?
The evidence from the best studies shows us that this management, not only for diabetes but for everything that surrounds it, brings more benefits. The new molecules that have shown the most beneficial impact control blood glucose and a series of other metabolic aspects such as weight reduction or blood pressure control that have an impact on the disease.
In addition, this is a hallmark of the internist. I believe that diabetes as a multipathological disease that has so many different legs is a disease for the internist. When a diabetic patient comes to us, we approach him comprehensively and we also look at his blood pressure, cholesterol, if there are associated comorbidities, his age, his social environment… We are a very good specialty for managing diabetics. Although we cannot pretend that we are all diabitologists. That is why we give general training, and for those who want to stand out more, we also have more specific training.
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“We see that there is very clear scientific evidence on certain drugs that have to be given to the patient yes or yes and it has not yet been done” |
Are doctors sufficiently trained?
We must continue with the previous momentum we have. We have improved a lot from where we were 16 years ago before the group was created, but we see that there is still a deficiency in terms of handling. It is something frequent, we see that there is very clear scientific evidence regarding some drugs that must be given to the patient yes or yes and it has not yet been done. It is something that not only happens in Internship, it also happens in Endocrine, Primary Care and Cardiology. We have to give the adequate tools so that this permeates the doctors and we are on that path. For example, our algorithm should reach all internists.
Do you think that Spain should transfer the European directive that declares obesity as a chronic non-communicable disease and design a national plan?
It should be done right now. Until it is recognized as a chronic non-communicable disease (NCD) and drugs are financed, as is done with diabetes, we are playing in inferior conditions. It is very difficult to deal with a problem of such magnitude when we do not play by the same rules of the game as other diseases. Nor do we have to do things quickly and quickly, but it is desirable that we begin to undertake a strategic plan that benefits our patients.
Have you been able to talk to the Ministry of Health regarding it?
The Diabetes, Obesity and Nutrition WG is the interlocutor for these issues internally and the first contacts have already been made, although there is still a long way to go. We have hopes and convention that it will be carried out. We do not know when and we are not in a moment of formal dialogue with the Ministry where it is marked what steps are going to be taken, but we believe that at least there will be no turning back.
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“Until obesity is recognized as a chronic non-communicable disease and drugs are financed, as is done with diabetes, we are playing in inferior conditions” |
What balance does the XVI meeting of the Working Group on Diabetes, Obesity and Nutrition?
It has been an immensely enriching forum of knowledge. When the scientific program was developed we tried to include advanced and basic aspects, together with highly relevant speakers, and the comments have been very positive. We have been doing a good job for several years and that is why we have had a full house. In short, the feeling has been of immense productivity for colleagues, which is what meetings are for
During the meeting, you have been in charge of the Working Group. What goals do you want to achieve during your term?
What I inherit is very good. I will have a continuation part and I will contribute some innovative idea. Training is on the right track, but we must give it a different approach, making it more dynamic and attractive to the youngest. I also think that there are new lines that should be opened like new technologies, that the internist has left them a bit abandoned. Another issue where I have a firm conviction is the benefits of collaboration with other working groups and other scientific societies. Every time we acquire more knowledge, but we do not make common paths. We also have to provide a service to patients and get documents for them.
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