Life-long struggle with diabetes

Published 12:00 am Saturday, December 24, 2005

The Selma Times-Journal

Meet Charles Liner &045; a 48-year-old Type 1 diabetic living in Selma.

Liner was diagnosed with diabetes at age six and has an advanced case of the disease. He’s admitted to being what he calls a &8220;bad diabetic&8221; in the past &045; not taking care of himself according to doctor’s orders. He’s suffered a stroke and has lost sight in his left eye. He’s facing kidney failure and amputation. His feet, he says, are &8220;atrocious.&8221;

Liner is in need of a physician who handles the most complex cases of diabetes &045; an endocrinologist. Unfortunately, there isn’t a single endocrinologist in Selma or Dallas County.

In a 2001 study performed by the Alabama Board of Medical Examiners, there are only two endocrinologists practicing in the Black Belt region, both based in Monroe County. The Black Belt has the highest incident of diabetes in Alabama and the nation. In an area where diabetes is rampant, why aren’t endocrinologists setting up practices?

The lack of endocrinologists isn’t solely a Selma issue, but a national issue. According to The Endocrine Society, endocrinologists are needed across the country. The total number of U.S. endocrinologists, roughly 3,000, is 12 percent less than demand. Even worse, the number of endocrinologists entering the market has fallen from 200 in 1995 to 171 in 1999 and the declining trend continues according to a report published by the American Diabetes Association.

Most endocrinologists in Alabama are based in Jefferson and Mobile counties, two counties that are home to large metropolitan areas. Montgomery County is home to seven endocrinologists, Selma’s closest access to this type of medical care. Taylor said he sends one to two patients a week to Montgomery.

When Liner had his stroke, he was rushed to UAB Hospital in Birmingham. He said the physicians who cared for him there were top-notch and gave him a piece of advice.

Steve Mahan, CEO of Vaughan Regional Medical Center, begs to disagree. He says although there are no endocrinologists in Selma, internal and family practitioners are doing an excellent job caring for diabetic patients.

Mahan said Vaughan is actively recruiting and is in talks with an international endocrinologist. The endocrinologist was scheduled to be in Selma in 2006, but there were no 2006 H1B visas available &045; the primary U.S. work permit for international professionals. Vaughan is hoping to have an endocrinologist in house in 2007.

Meanwhile, Taylor said he and other area physicians are working closely with Montgomery endocrinologist and founding member of the American College of Endocrinologists Bruce Tripp to achieve a better understanding of complex diabetes cases.

Tripp’s goal, Taylor said, is to train primary care doctors to be junior endocrinologists.

Liner doesn’t think Selma can afford another year to go by without an endocrinologist.