Dr. Lina Mitchell has journeyed far to find herself back in Cincinnati, poised to be a community leader in the battle against diabetes as the lead phys ician at the new Mercy Diabetes Center in West Chester. And she relishes the challenge.

"It's a great asset," she says with enthusiasm about the center. "It's very exciting for me to be part of this."
Dr. Mitchell was a young cardiologist in the early 1990s, practicing in her native Lithuania, when she first thought about pursuing a different professional path. "As a cardiologist, I saw a lot of patients with diabetes," she recalls. "I wanted to help them, and I found I could combine my knowledge of cardiology with the problems that people with diabetes have to deal with."

After earning her medical degree in Lithuania, she gained nine years of experience in internal medicine and cardiology before coming to the U.S. Her local connection began in 1999, with a three-year residency at The Jewish Hospital"”and she left with a favorable impression of Greater Cincinnati. Dr. Mitchell then spent four years of training and practice in endocrinology at SUNY Stony Brook in New York.

Meanwhile, Mercy Health Partners"”like many hospital organizations"”was becoming more focused on helping people prevent or manage chronic diseases such as diabetes, instead of showing up in emergency rooms with acute, life-threatening conditions. The number of such cases keeps rising everywhere, including among the booming population of Butler County. So creating the diabetes center was not just wise but necessary, says Mercy Hospital Fairfield spokesman Greg Ossmann.

Cardiology may be more prestigious and profitable, but the demand for top endocrinologists"”the doctors who specialize in disorders of the endocrine system and the hormones it produces"”far exceeds the supply. Dr. Mitchell notes that the national average waiting time to get an endocrinologist appointment is approaching two months.

This specialist shortage coincides with diabetes"”classified as a global epidemic"”becoming a U.S. health crisis. Nearly 21 million American children and adults have diabetes, but as many as 6 million or more are unaware they have the disease, according to the American Diabetes Association. People with diabetes are at higher risk of heart attack, stroke, kidney disease, blindness and other serious health consequences. The rapid rise in Type 2 diabetes mellitus (often mislabeled as "adult onset") is largely associated with escalating obesity and lack of exercise. This particularly alarms health professionals, who are seeing more Type 2 diabetes cases among children.

Dr. Mitchell, her associates and Lea Ann Dick, Mercy's regional director of Diabetes Services, hope the new center will raise awareness and identify people at risk of diabetes, or those in the early stages of the disease. That's not easy. People can have Type 2 diabetes without obvious symptoms. And the fear of finding out is common, especially among those with a family history of diabetes.

"They probably realize, they know in the back of their minds, that they have to make lifestyle changes," Dr. Mitchell observes. "And they might fear the complications they saw in family members."

Routine screening would make a huge difference, says diabetes specialist Dick. But insurers tend to follow Medicare's lead on covering test costs, and Medicare began covering blood sugar lab tests only in the past year"”and then only for patients in certain risk categories. Ideally, she says, Americans of all ages with any risk factors"”especially obesity"”would be checked at least annually.

Advances in diabetes treatments, along with weight control and other lifestyle adjustments, make it easier for people to manage the disease and lead relatively normal lives. Inhaled insulin, for example, "is very exciting for patients who have a fear of multiple insulin injections," Dr. Mitchell notes.

The Mercy Diabetes Center integrates many healthcare specialists, because people with diabetes usually have complicated health issues. "It's an unusual patient with a single endocrine problem," Dr. Mitchell explains. "Usually, multiple things are happening. That's why a more detailed evaluation is valuable."

Her objective, however, is to empower her patients, not make them more dependent.

With the right approach, she says optimistically, "you'll be in charge of this condition"”not have the condition in charge of your life."