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Health

Dr. Spyros Mezitis on the Current Management of Diabetes Mellitus

NEW YORK – Dr. Spyros Mezitis, MD, PhD, one of the best known endocrinologists in New York City with many years of experience in managing complicated cases, is Assistant Professor of Clinical Medicine/Endocrinology at Cornell University’s Weill Medical College. He spoke to The National Herald about the symptoms and dangerous complications of diabetes mellitus. Over 500 million people suffer worldwide of this chronic disease, and by 2030 this number will surpass 640 million individuals. Half of the diabetic population is undiagnosed, two out of three diabetic patients live in urban environments and 4 million people die annually of diabetic complications. Concurrently, the cost of diabetes management (medical and lost work hours) has skyrocketed to $250 billion annually. Ten percent of the world’s health spending goes to diabetes health care.

Dr. Spyros Mezitis grew up in Athens, Greece, was a student at Athens College, studied medicine at Heidelberg University, Germany, and Thomas Jefferson University, Philadelphia, Pennsylvania, completed his BS and PhD/Neuropathology at the University of Pennsylvania, residency training in Internal Medicine at Thomas Jefferson University Hospital, subspecialty training in Endocrinology, Diabetes, and Metabolism at the combined Fellowship Program of New York-Presbyterian Hospital, Memorial Sloan Kettering Cancer Center, and the Hospital for Special Surgery in New York City.

Dr. Mezitis was President of the Hellenic Medical Society of New York in 2000-2004 and is currently President of the Federation of Hellenic Medical Societies of North America, Inc.

TNH: Dr. Mezitis, why was the disease named diabetes mellitus and why is this chronic disease so common?

Dr. Spyros Mezitis: Blood sugar (glucose) is high in blood and the human body increases sugar excretion in urine (diabetes) that adopts a sweet smell and taste (mellitus).

In today’s society, we have distanced ourselves from the natural physical lifestyle and factors increasing blood sugars include high sugar consumption, low exercise, increased weight, aging, stress, sleep deprivation, and family history. Currently, one in ten adults suffer from diabetes globally, one third of adults are prediabetic without knowing it. In order to grasp the rapid rise of this epidemic better, just figure that our daily sugar consumption has increased ten times with the sugar content of processed foods skyrocketing since 1970!

TNH: How does the human body control blood sugars and what goes wrong in diabetes?

SM: Our body has an abdominal organ called the pancreas that secretes insulin, the hormone that allows the blood sugar to enter muscle and nerve cells and serve as fuel. The pancreas produces less insulin in diabetes type 2 and no insulin because of immunological attack in diabetes type 1 that begins mostly in childhood/adolescence.

TNH: What are the specific criteria for diagnosing diabetes?

SM: The clinicians use the Hemoglobin A1c (HbA1c) which is a blood test denoting three months of sugar control and is above 6.5% in diabetics along with a 8-hour fasting glucose greater than 125 mg/dl.

TNH: And if the sugar is high in the blood what happens?

SM: First, we observe the symptoms of thirst, polyuria, weakness, weight loss, and blurry vision but secondly with time high blood sugars cause inflammation of the blood vessels leading to microangiopathy of nerves, kidneys, and eyes and later macroangiopathy of the heart and brain.

TNH: What should we do to control diabetes?

SM: The conservative lifestyle includes strict low carbohydrate diet, daily aerobic exercise, stress relief, increased sleep that help in reducing fat cell numbers that secrete adipokines causing insulin resistance.

Research and clinical medicine have progressed immensely with medications that increase insulin secretion and reduce insulin resistance, insulin pen use with action of varying duration, sophisticated glucometers, insulin pumps connected to continuous glucose monitoring devices mimicking normal body physiology that secretes insulin continuously dependent on the blood sugar levels, and novel research in the enteric microbiom.

TNH: How can we control the rapidly rising incidence of diabetes worldwide?

SM: You are right about the uncontrolled increase of diabetes worldwide! On one hand, medicine is moving ahead on a closed loop insulin pump system – bionic pancreas, in stem cell conversion to insulin producing cells and infusion into the human body; however on the other hand, each country should set limits on carbohydrate content of processed foods and drinks, and establish guidelines for mandatory exercise of the workforce.

The epidemiological studies show more rapid increase in this chronic disease in countries of Southeast Asia – India and China where people are engaging in fast food consumption and have replaced walking and biking with machine driven vehicles.

The population must be educated on the significant complications of uncontrolled diabetes that constitute the primary cause for blindness, kidney failure, and limb loss, and together with hypertension and hyperlipidemia cause heart attacks and strokes.

The medical doctors, other health professionals, bioscientists, professional societies, and government agencies should collaborate in confronting this deadly epidemic both at the personal and population levels.

TNH: What are your conclusions on using the diabetic telemedicine platform?

SM: The COVID-19 pandemic was tied with increased diabetes incidence in hospital patients and establishment of telemedicine as a successful treatment strategy.

The diabetic telemedicine platform for close monitoring of diabetic patients shows improved diabetes control and decrease in microangiopathy compared to patients followed in person at less frequent intervals. My research team is working on demonstrating more positive results in the near future.

More information is available online: https://drmezitis.com.

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