Issue: September 2016
Section: Diabetes views
The future of type 1 diabetes care
I have spent the last 38 years primarily treating individuals with type 1 diabetes. In that time, I have been involved with over 400 pregnancies of individuals with type 1 diabetes with virtually no complications, and in the last twenty years, I have no cases of blindness, renal failure or amputations. Looking back, I am extremely pleased with the career choice I made. While not the most lucrative career, it has been extremely satisfying.
Unfortunately, I do not believe nearly enough individuals will pick a career focusing on type 1 diabetes in the next ten years leading to a major shortage and a concomitant decrease in care for the individual with type 1 diabetes. A study by the Association of American Medical Colleges (AAMC) suggests there will be a shortage of 5,100 to 12,300 physicians in medical specialties by 2025. This covers all medical specialties. Already today there is a 15% deficit in endocrinologists but unfortunately there is no good data on the shortage of physicians treating type 1 diabetes among endocrinologists. Among the last ten endocrine fellows I have trained only two have expressed any interest in primarily seeing individuals with type 1 diabetes and even their future plans are not certain. In other parts of the world, the situation is even worse.