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EDITORIAL |
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Year : 2017 | Volume
: 15
| Issue : 3 | Page : 165 |
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Diabetes mellitus: The responsibility of the generalist and specialist
Nihal Thomas
Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
Date of Web Publication | 7-Aug-2017 |
Correspondence Address: Nihal Thomas Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore - 632 004, Tamil Nadu India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/cmi.cmi_68_17
How to cite this article: Thomas N. Diabetes mellitus: The responsibility of the generalist and specialist. Curr Med Issues 2017;15:165 |

Diabetes mellitus can no longer be thought to be just a monothematic disorder, and is a disease that encompasses a vast and complex milieu of symptoms and complications which floods the entire breadth of general medicine. Developing the skills to handle and treat this multifaceted disease should be the responsibility of every generalist and it would be self-defeating to say that management of this condition should be the domain of just the specialist.
The spectrum of oral hypoglycemic agents that fills the racks of pharmacy shelves is complicated and confusing. Having a simple and cost-effective algorithm to use what is necessary in a step-wise, yet individualized fashion is a priority. As in many medical disorders, the remedy of the disease could be one's Waterloo – for infections, it is antibiotic resistance. Hypoglycemia is the Waterloo of diabetes – a haunting experience of hypoglycemia is the patient's nemesis and may institute a fear complex in addition to increasing the risk of morbidity and mortality. It is, therefore, important to have an appropriate strategy to tackle this disorder.
Since the days of Ida Scudder, the founder of Christian Medical College, Vellore, the importance of women's health as a foundation of a robust public health-care system has been prioritized. Now, with the deluge of obesity coupled with reduced physical activity, the importance of targeting the women in the reproductive age group and preventing or treating early gestational diabetes has emerged as a major public health challenge. To present a trans-generational catastrophe (which is what gestational diabetes is all about), the global strategy should involve handling the girl child in school with kid gloves and espousing a healthy lifestyle from then onward through marriage, pregnancy, and the postnatal period.
We have a collective responsibility as a medical community to develop a culture that should emphasize proper primary and secondary prevention of this acquired pestilence. This is important as diabetesconstitutes a significant burden to both health-care systems, and to society in the form of permanently disabling social sequelae, while also adding a significant financial impact on the family as a unit.
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