Meet our Docs: Vishwanath Pattan, M.D., believes helping patients control diabetes can have big impact on entire community
By Kristy Bleizeffer Sep 9, 2016
Since 2001, Wyoming’s diabetes rate nearly doubled. About 29 percent of Wyoming adults are obese, a leading risk factor for type 2 diabetes, according to a new report from the Robert Wood Johnson Foundation and the Trust for America’s Health.
About 8.4 percent of Wyoming adults are now diabetic, and that poses serious health risks. Type 2 diabetes puts people at higher risk for heart attack, stroke, kidney disease, eye disease and other complications.
You probably know someone with diabetes, or you will in the not-too-distant future. As many as 79 million people in the United States have pre-diabetes, yet more than 90 percent of them don’t know it.
“Diabetes impacts almost every aspect of health from the results of surgery to pregnancy outcomes. It increases impacts of cardiovascular disease and is a major killer in that regard,” said Vishwanath Pattan, M.D., an endocrinologist. “It is a major challenge for public health as well. I believe by learning to control this disease, we can make an impact on the health of society.”
Casper hasn’t had a full-time endocrinologist for several years. Dr. Pattan recently joined Wyoming Endocrine and Diabetes Clinic in Casper, which helps patients who are now traveling out of state for diabetic care. He is board certified in internal medicine and completed an endocrinology research fellowship at Mayo Clinic and a clinical endocrinology fellowship at Harbor UCLA/City of Hope in California.
Where did you grow up and how did you become interested in medicine?
I grew up in India, in a state called Karnataka. We had a very good government medical college in my hometown of Hubli called Karnataka Institute of Medical Sciences. I was always interested in biology, and whenever I would pass by, I used to dream that I was in that medical center. I did my entrance exam and ended up there for medical school.
After I finished my medical school, I ended up training in All India Institute of Medical Sciences in New Delhi. Then, I did clinical research and pharmacology and on into epithelial dysfunction using statins and fluticasone comparison groups.
From there on, I wanted to do something in endocrinology, so I ended up at Mayo Clinic. I did clinical translational research in endocrinology at Mayo Clinic for two years. I then joined a residency in New Jersey at Raritan Bay Medical Center and was given a third year chief residency position. I wanted to join a fellowship in endocrinology and I chose Harbor-UCLA and City of Hope in California.
Why did you want to specialize in endocrinology?
India is the diabetes capital of the world. There are a large number of diabetics, and it has become more and more rampant; almost like a pandemic. I thought I could make a big impact for patients.
Diabetes is also a challenge because, so far, there is no cure. It is a major challenge in public health. It places a big public burden on both survival and quality of life. I think endocrinologists can make an impact on the health of society.
What are some treatment advancements that have you excited?
One that I encountered at City of Hope was the islet cell transplant protocols which are newer. The islet cells are cells in the pancreas which produce insulin. They are called beta cells in the islet. New investigational steps have had a setback because the survival of these cells were very low and were subject to immunological attack. At City of Hope, they are trying to grow them in culture with some immunological moderators in such a way that they are given to a patient that the reaction rate is very low. There are success stories to tell. I think this is an ongoing process and it gives hope for a cure. I am excited about that.
How many years before you think that might be viable for patients with diabetes?
It might take at least a decade because it is a large challenge.
Other than that, new medications are always being tested. People do not like insulin because it is intractable. All patient preferences are for oral medications, and we have seen a lot of newer medications in this class.
The limitations have remained the same. None of them prevent the progression of diabetes, although it will slow down the progression by better controlling sugars.
The prevalence of type 2 diabetes is increasing in Wyoming and Natrona County, despite efforts to promote prevention. Why do you think this might be?
It seems that there has been a lack of endocrinologists and treatment resources here. I heard patients are traveling to Utah for treatments. When people have to migrate for treatments, then the number of visits decreases. Patient education and follow-up are not as as effective.
Once they are here in the office and we discuss the benefits of education and weight loss, exercise, healthy choices for diet and nutrition, I think patients will also influence their children’s health. Parents influence what children are eating, and the better habits will automatically reflect that to another generation. I think it impacts prevention indirectly.
You can slow the progression of diabetes and prevent pre-diabetes from becoming diabetes with a good regimen of exercise and good nutrition. We have seen patients who have had bariatric surgery, and many of them do not need to be on insulin any more. Something like 60 percent of them go off medications.
Do you have advice for how people can incorporate healthy habits into their daily lives?
As far as exercise, the new guidelines recommend that you need 150 minutes of exercise each week, but you should not go two days in a row without exercising. I think it’s helpful to have a scheduled time for exercise. People will say they walk a lot in their work area, but to be honest, they will also be sitting a lot in front of a computer.
People should also watch their snacking. I do not think people realize how many calories they get snacking. They do not count it. When people are stressed out, the stress reliever is food.
Mindful eating is a concept where people choose a food, and they have to think about the source. How was it made? For example, green leafy vegetables come fresh from nature and don’t have a lot of calories. But they are packed with vitamins and fiber. Mindful thinking about how much saturated fat a food has? How many preservatives? How was it processed? When they start looking at these, they become more and more aware when they pick up a can and look at the nutrition label. The habit of looking at nutrition labels influences the food choices they make.
What do people need to know about Wyoming Endocrine and Diabetes Clinic?
When people come in for diabetes and they say they want a diabetic diet, I want to tell them that a diabetic diet is not just for diabetes. I think it is for everyone, young or old, as that is a healthy diet in general. It is good for heart patients, good for young healthy patients.
When we say a patient has heart disease, the pathology started probably in their teens or even younger. Blood vessels accumulate cholesterol plugs at a very early age. I think that education about living a healthy of life – with exercise, diet and choice of nutrition – goes a long way.