Dr. Subhash Kumar Wangnoo is currently heading the Apollo Centre of Obesity, Diabetes and Endocrinology (ACODE) at Indraprastha Apollo Hospital, New Delhi. He trained in medicine at Banaras Hindu University, where he developed keen interest in the field of diabetes, endocrinology and metabolism. Furthering his interest in this field he qualified for the D.M. specialization in endocrinology in the year 1984. During the course of his work for writing the doctorate thesis towards awarding of D.M. degree, he published over 50 papers, books and reviews on aspects of diabetes, ranging from basic studies on metabolism to aspects of the organization and delivery of diabetes health-care.
Please tell us about your journey from MBBS till becoming the Honorary Physician Endocrinologist to the President of India.
I did my MBBS from BHU, and then in a row did MD in Internal Medicine and DM in Endocrinology from BHU itself. I then worked as a pool officer for 3 years, after which, I got the opportunity to establish and head the Endocrinology department at Shere-e-Kashmir Institute of Medical Sciences at Srinagar. Due to some insurgencies, I had to leave that place and came to Delhi. I worked at Saudi Arabia for 3 years. In 1995, I joined the Indraprastha Apollo Hospital since its inception, and the journey is still continuing. I had a pioneering role in establishing the Apollo Centre for Obesity Diabetes and Endocrinology (ACODE), which is a successful state of the art tertiary care centre for diabetes and endocrinology. I am also actively involved in the training of the DNB Endocrinology superspeciality program at our hospital, which has been running successfully for more than 8 years.
India has been labeled as the Diabetes capital of the world. Do you think we have enough trained doctors to deal with this problem?
No, India does not have enough trained doctors as of now, to deal with the rapidly increasing population of diabetic patients. But we are making efforts to train the existing doctors to treat diabetes with a minimum standard of care. I am one of the National Experts on the advisory board for a certificate course in evidence based diabetes management run by public health foundation of India, and recognised by the International Diabetes Federation.
Diabetes management involves close association with other branches like surgery, ophthalmology, etc. How do you manage this integration in your center?
Diabetes management requires an inter-disciplinary approach involving an endocrinologist, diabetes educator, ophthalmologist, podiatrist, surgeon, nephrologist, etc. and cross referrals should be there for the patient benefit. Ours being a tertiary care centre, we have all the said specialities, and hence, a comprehensive care is given to the patient under one roof. A diabetes management centre should at least have a podiatrist, diabetes educator, and ophthalmologist, in addition to the endocrinologist or the primary care physician specialising in diabetes.
What are your thoughts about the use of mobile health technology in the field of doctor networking? Do you think, it can be used to guide doctors in second and tier cities manage their patients?
Advancements in technology have come a long way in patient care and is still ongoing. Mobile health technology is upcoming in the field of doctor networking as well as patient care. We are already using telemedicine facilities at our centre to help guide doctors to manage their patients. We are also using mobile health apps in our patients of diabetes and obesity to keep them motivated and guide regarding nutrition, exercise etc.
Childhood obesity is being labelled as the next big health problem in our country. What are the main causes behind it and how can it be prevented?
Childhood obesity is the next epidemic in line. The increase in the caloric intake- use of junk food, processed food, ready to eat items, frequent eating out, larger portion sizes available for same price, etc- coupled with the lack of physical exercise and increased sedentary habits, is the reason behind this major increase in childhood obesity. Obesity translates into future type 2 diabetes, dyslipidemia, hypertension, metabolic syndrome, and cardiovascular disease. The rise in childhood obesity can be prevented by making the children and their parents aware about obesity and its ill effects; also everyone should adopt healthy lifestyle practices like cutting down on junk and processed food, and increase the physical activity.