[Viewpoint]Common cause against diabetesA diabetes patient living in Seosan, South Chungcheong Province ignored his doctors’ advice and kept his medicine stashed away without taking the drugs regularly. Then about a month ago, as he was clipping his nails, he found two of his toes had turned a dark color.
He went quickly to a hospital in his neighborhood only to hear a horrific diagnosis: his foot below the ankle would have to be amputated. He went to a general hospital in Seoul for a second opinion and the medical examination revealed the diabetic symptoms had developed not only into the necrosis affecting his toes, but to retinitis and complications in his coronary arteries. Therefore, it was unavoidable that he have his foot removed, have laser surgery on his retina and have heart surgery to repair his damaged arteries.
Sadly, this kind of case is not unusual in our diabetes clinic.
According to An In-Depth Analysis of Research on Diabetes Patients Selected on a Random Basis in 2005, a report made by the Health Insurance Review Agency and the Diabetes Association of Korea, the number of patients assumed to be diabetics in the country is now about 2.69 million. In other words, one out of 13 adults, or 7.75 percent of the adult population, are diabetic. Moreover, 300,000 people are diagnosed as new diabetic patients annually. The medical treatment for diabetes amounts to 3.2 trillion won ($3.3 billion) annually, which is about 19.3 percent of total medical costs covered by the national health insurance.
Although the threat of diabetes is is a serious social problem, the effort to cope with it by the government has been lukewarm. In advanced countries, the government spares no effort to provide education on diabetes and the prevention of complications from the disease.
In Finland, an experimental program designed to prevent 522 obesity patients from developing the disease was undertaken, and it was proven that the number of patients who developed diabetes could be lowered by 58 percent if the individuals lost an average of 3.5 kilograms. In such countries as the United States, England, Japan and Sweden, they cope with the rapid increase in diabetic patients by providing prevention programs. South Korea, too, tried to establish a management system for high blood pressure and diabetes by classifying them as chronic diseases, but the effort did not progress. It still remains on the level of statistical research.
In order to control diabetes, what is no less important than providing good-quality medical service is restructuring the insurance system and establishing a system of cooperation among medical organizations so that diabetes can be managed in a systematic way. At the same time, it is important to launch diverse publicity campaigns on a national level and develop educational materials suitable for our reality.
In the United States, diabetes education programs are provided by some 20 federal and private organizations, including the National Institute of Health and the Center for Disease Control and Prevention. The health authorities also provide systemic education and publicity materials to all communities so that as many people as possible can learn about the disease and how to cope with its implications.
South Korea, too, must concentrate on establishing a system to effectively disseminate information and manage diabetes by developing suitable programs to check the alarming rise in complications. Specialized diabetes clinics and the diabetes association, which have vast experience in the treatment of patients with the disease, should work with the support of the government to develop first-rate educational materials and get that information out to the public in creative and systematic ways.
Diabetes and its debilitating complications can be prevented through proper education and lifestyle adjustments. Therefore, diabetes associations here and abroad have concluded that education is a part of medical treatment.
In Korea, however, since a medical doctor might see over 50 patients in a day, it is not always possible to both manage and educate patients at the same time. Also, most Korean hospitals do not have the systems to allow doctors to carry out programs for the proper management and education of diabetes patients.
Therefore, the wholistic treatment of diabetes patients should be systematized with the assistance and cooperation of other medical organizations. It is necessary, for example, to designate one hospital as a regional center for diabetes referrals in local areas. It is also urgent that medical insurance cover the expenses of education and prevention.
It will be necessary also for government to support research on the causes and possible cures for the disease, by tapping the wide experience of domestic medical organizations.
The response may be late, but we can still prevent the rapid rise in the number of diabetics if all concerned parties work together to find a solution.
*The writer is the head of the diabetes care center at Kangbuk Samsung Hospital. Translation by the JoongAng Daily staff.
by Park Sung-woo