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Table of Contents
EDITORIAL
Year : 2020  |  Volume : 24  |  Issue : 5  |  Page : 377-380

The President's message, 2019-20 strengthening endocrinology: Towards a sustainable future


Department of Endocrinology, Bharti Hospital, Karnal, Haryana; All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Date of Submission05-Oct-2020
Date of Acceptance09-Oct-2020
Date of Web Publication9-Nov-2020

Correspondence Address:
Sanjay Kalra
Bharti Hospital, Karnal - 132 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijem.IJEM_670_20

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How to cite this article:
Kalra S. The President's message, 2019-20 strengthening endocrinology: Towards a sustainable future. Indian J Endocr Metab 2020;24:377-80

How to cite this URL:
Kalra S. The President's message, 2019-20 strengthening endocrinology: Towards a sustainable future. Indian J Endocr Metab [serial online] 2020 [cited 2020 Nov 29];24:377-80. Available from: https://www.ijem.in/text.asp?2020/24/5/377/300338



Endocrinology, a young branch of medicine, has grown dramatically during the past century. The strong representation of endocrine scientists in the list of Nobel Prize laureates reinforces the importance of our discipline to modern health.[1] Advances in physiology, biochemistry, pharmacology, and imaging have helped improve clinical management over the past few decades. The growing pandemics of diabetes, obesity, and cardiovascular disease underscore the need for further development in our field.[2]

In spite of the vast spectrum that endocrinology represents, endocrinologists often find themselves boxed into a corner. The beauty and breadth of endocrinology acts as a magnet for practitioners of alternative medical systems. These persons market themselves as hormonal specialists, and use unvalidated and unscientific means to spread disinformation amongst the gullible public. More often than not, this creates a communication gap between the community and us. This in turn acts as a barrier to acceptance of and adherence to modern endocrine care. Irrespective of the etiology, however, the responsibility for addressing this information discordance rests with qualified endocrine care professionals.[3]


   Person Centered Endocrinology Top


Much has been written about person centered care, and how it is applicable to endocrinology.[4] In this communication, let us explore a few facets of person-friendly endocrine care which can help bridge the gap between endocrinology and the community. Our aim is to foster thoughts, words, and action, which can help improve health care seeking, acceptance and adherence, and lead to optimal endocrine health for all.


   Glucocrinology Top


Diabetes, which is primarily an endocrine disorder with multisystemic manifestations, is often perceived through a cardiovascular prism. To ensure a balanced discourse, we have crafted the term glucocrinology. Glucocrinology refers to the bidirectional relationship of glycemia and endocrine function. This concept underscores the need to study endocrine physiology, and endocrine pathophysiology in order to understand glucose metabolism and its disorders. This concept has given rise not only to conceptual papers, but to an entire book,[5] as well as an international conference hosted by Endocrine Society of India (ESI) (courtesy Sandeep Julka, Indore, 2019). The term is used frequently in endocrine conversation in India and neighboring countries, and finds mention in the agenda of various educational meetings. The philosophy of glucocrinology is to promote holistic, endocrinology-led delivery of diabetes care.


   Mind Body Medicine Top


The word 'holistic' leads us to the subject of Mind Body Medicine (MBM). MBM is used to describe health assessment interventions that address the physical, biomedical, psychosocial, and mental aspects of health. Endocrine function is not limited to the working of hormones: it includes, and is impacted by the autonomic nervous system. While the discipline of neuroendocrinology focuses more upon the biochemical correlation of the nervous and endocrine systems, MBM takes a clinically relevant, patient oriented, preventative as well as management driven approach.[6] MBM has found its root in Indian endocrinology, with ESI holding the first ever international conference on Mind body Medicine in Endocrinology at Pune, 2020 (gratitude to Vaishali Deshmukh, Ameya Joshi).

Along with MBM, the role of religion as a motivational tool to help improve acceptance and adherence of therapy, and improve health, is entering mainstream science.[7] The role of religion is not limited to patients: this can be used to benefit health care professionals as well.[8] I am mindful of the criticism this concept has faced within certain circles. I would categorically like to state that no where do we promote a particular religion or philosophy. Rather, we identify the best of existing scriptures, and share it with colleagues so that they are empowered to serve their community in a better and friendlier manner. If the patient we are treating is motivated by religiosity, we should not hesitate to use religion as a motivational tool.

I would like to record the yeoman service of our members in spreading this concept beyond India's borders (Buddhism and diabetes care in Myanmar: Gagan Priya, Ameya Joshi, Girish Parmar). ESI's active team have simplified guidance on endocrine and diabetes care during the Ramadan and the Hajj, (leadership: AH Zargar, Shehla Sheikh)[9] as well as during other region-specific and religion-specific fasts and feasts.[10],[11]


   Community Endocrinology Top


As the astute reader must have discerned, this opinion piece makes frequent mention of the community. All health care professionals, and all endocrinologists, are part of a larger community and ecosystem. With our community, we prosper. Without it, we lose our raison d'etre.

Various Indian writings have highlighted the importance of person-centered endocrinology, community endocrinology and eco-sensitive endocrinology (or green diabetology).[12],[13] These reinforce the need to involve the community as an active partner in all our activities. The choice of our webinar themes, including Transgender Endocrinology and Gender sensitive Endocrinology, as well as monthly international webinars, such as Endocrine Nursing, demonstrate an inclusive approach to the definition of the endocrine community, as well as the society that we serve.


   Wellness Endocrinology Top


One of our most proactive outreach activities has the concept of wellness endocrinology. Wellness endocrinology utilizes knowledge of endocrinology to ensure optimal health for every member of society. Wellness endocrinology aims not only to manage, but to prevent endocrine dysfunction, and to promote optimal endocrine health among the public at large. A committed team of young Indian endocrinologists has been spearheading this theme, by interacting with the public through various social platforms[14] (special mention Mohan T Shenoy, MN Satyavani, Ashok Venkataranasu, Nitin Kapoor, Gagan Priya). This is one area where India has emerged as a global leader, both in thought and in action.


   Glycemic Happiness Top


Yet another philosophy we have initiated is that of happiness, including euthymic euglycemia, or glycemic happiness.[15] Currently, the definition of optimal diabetes care is based solely upon achievement of targets. We suggest that happiness, or quality of life be included as an integral part of our target. Happiness, in fact, can be viewed as a target as well as a tool to achieve this target. Similarly, in obesity, we call for a more comprehensive approach to assessment and management: obesity should be viewed as much more than a mere body mass index (BMI).[16]


   Youthful India, Colorful India Top


All work and no play make us sick. Therefore, ESI believes in work life balance. The Colors of India cultural event has become a regular affair at our conferences (credit to Gagan Priya, Altamash Shaikh, Shehla Sheikh, Abhay Sahoo, Sambit Das, Sunil Kota, Belinda George, Indira Maisnam, Prem Narayanan, Om Lakhani). Our themes: Fashion and Fabrics of India (2016), Sports Endocrinology (2018) and Happy Hormones, Healthy Hormones (2019) reflect our attitude towards life.

The motto of one of our state teams- “Haryanvi Hormones are Happy Hormones”, -reveals a quest for health and zest for life (”thara bhala ho”: “gadar” captains Sameer Aggarwal, Rajat Gupta and “andy” team of Arun Kumar, Ashok Kumar, Atul Dhingra, Dheeraj Kapoor, Hiya Boro, Manoj Kumar, Neelam Pandey, Parjeet Kaur, Rajneesh Mittal, Sandeep Chaudhary, Sandeep Kharb, Sunil Mishra, Yogesh Yadav). The bhangra team has shown the importance of a healthy lifestyle by example, rather than by words (meharbani to the mutiyaars Inderpreet Kaur, Kirtida Acharya, and gabrus Jubbin Jacob, Rajeev Khanna, Ramanbir Singh, Rakesh Goel, Mandeep Singla, Neeraj Garg, Parul Jain, Sachin Mittal, Sandeep Julka).

The Yuvacrinology team (Prof SV Madhu, KVS Hari Kumar, Vijaybhaskar Reddy) is a novel initiative which tries to harness the energy and enthusiasm of our younger members (those young at heart) to ensure all round development. Our team is working to create meaningful collaboration with early career endocrinologists across the world as well (Tejal Lathia, Om Lakhani, Sunil Kota).


   Regional Action, International Collaboration Top


Indian endocrinologists have been working at local level to enhance endocrine awareness and education. ESI's annual events, the ESI AV Gandhi Award (SV Madhu, Sujoy Ghosh), ESI TYSA Award (Arundhati Dasgupta, Sanjay Saran, Sahana Shetty, SS Mangaraj, Ashish Sehgal, Om Lakhani, Prem Narayanan), EnSPIRE (Nishant Raizada, Nitin Kapoor) and ESI Fundamental Research workshop (Alpesh Goyal, Yashdeep Gupta; leadership Prof Nikhil Tandon) have emerged as pole stars on our academic calendar.

Though we were able to have only one ESI Satellite Symposium this year (Madurai, the temple city of India, the tilak of Tamil Nadu: gratitude to V Kumaravel, S Sridhar), our members have held excellent endocrine meetings at state, national and global level (examples, SPEED led by Sameer Aggarwal, Saptarshi Bhattacharya; Coimbatore, Suresh Damodharan). The Kerala, Odisha, Tamil Nadu and West Bengal state chapters of ESI have conducted, or are planning annual conferences in virtual mode, and provide a platform for our fraternity to share their knowledge.

While being proud Indian nationals, we are also responsible citizens of the world. ESI is a founder member of the South Asian Federation of Endocrine Societies (SAFES) and enjoys close and cordial relations with all neighboring countries. We contribute to the International Society of Endocrinology (ISE) with vigor and zeal: our enthusiastic participation is reflected in the education section of the ISE website as well as its newsletter.[17] The weekly webinars of ESI, as well as our Endocrine Week, scheduled for November, have been accredited by ISE (credit to KVS Hari Kumar, Saptarshi Bhattacharya, Shehla Sheikh). Our website[18] facilitates communication between our members, the society leadership, and the entire world (thanks to Prof Rakesh Sahay, Srinagesh, Deep Dutta).


   Hormonal Harambee: Working Together Top


On the canvas of life, endocrinology is but a small discipline, and we are insignificant foot soldiers. If we work together, however, to contribute to the growth of our chosen subject, and to the well-being of our society, we can punch far beyond our weight, and fulfill our purpose. The Swahili word 'harambee', which means 'to pull or work together' is an apt slogan for us.

By enhancing focus on these facets of endocrinology, we can strengthen our discipline, and ensure sustainable growth for ourselves. In no way do we negate the importance of basic science, core clinical competence and academic research our field. Standing on the broad shoulders of our illustrious seniors, we hope to leave a better ecosystem for those who will follow and replace us.

In fact, we visualize an “anandaloke, mangalaloke (an abode of joy and bliss” (Rabindranath Tagore) (”dhonnyobaad” Debmalya Sanyal, Soumik Goswami, Sujoy Ghosh), where endocrinologists are able to translate their research and technology into meaningful benefit for the population at large, to prevent as well as manage endocrine disease, and to promote endocrine health. Such a state, if achieved, will ensure that endocrinology continues to strengthen, and sustain, with humankind.

Acknowledgements

Serving the ESI has been a matter of both pride and humility for me: pride, as I have been able to contribute to the growth of our subject, our society and our country; humility, because I realize that there is a lot more that could have been done.

Our communication has been facilitated by WhatsApp groups Endocrine United (administrator Deepak Khandelwal, Nilakshi Deka, Srinagesh, B Vivekananda), Frendos (Ameya Joshi, KVS Hari Kumar, Saktivel S, Srikanth Kongara) and Amigos (Mohan T Shenoy, Om Lakhani, Karthik Balachandran). These groups have helped create bonhomie amongst us, which was further nurtured by our lockdown quiz (Quizmasters Prathosh Gangadhar, Vimal MV). My friendly PEER group (AG Unnikrishnan, Ganapathy Bantwal, Manash P Baruah, Mathew John, Rakesh Sahay) and colleagues from Karnal (Ashish Sehgal, Pramila Dharmashaktu) and Rishikesh (Kalyani Sridharan, Kriti Joshi) supported me to the hilt.

I thank Prof SV Madhu, Immediate Past President, ESI for having provided me with a robust platform to work upon. Past Presidents Prof Nikhil Tandon (who was my guide during DM), Prof Ambrish Mithal, Prof SK Singh, Prof Subhankar Chowdhury, Prof Sarita Bajaj, Prof AH Zargar and Prof Prasanna Kumar have guided me throughout my career. The ESI Executive Committee has been a source of great support, especially Prof Ganapathy Bantwal, President elect, Prof Rakesh Sahay, Vice President, Prof Sujoy Ghosh, Secretary, Dr KVS Hari Kumar, Joint Secretary and Dr Kaushik Pandit, Treasurer. The entire committee[19] has worked tirelessly to ensure that ESI stands tall as an organization of like-minded professionals. Most importantly, I acknowledge the respect and affection from all members of the Indian endocrine fraternity: this is a treasure that will last not just a lifetime, but my next seven existences as well.

I apologize for any shortcomings, and for not having been able to mention by name all the persons who have contributed to the development of Indian endocrinology.

Jai Hind. Jai ESI.



 
   References Top

1.
Kalra S, Unnikrishnan AG, Jacob J. Endocrinology@ the nobels. Indian J Endocrinol Metab 2012;16(Suppl 2):S138-9.  Back to cited text no. 1
    
2.
Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep 2018;20:12-20.  Back to cited text no. 2
    
3.
Baruah MP, Kalra B, Kalra S. Patient centred approach in endocrinology: From introspection to action. Indian J Endocrinol Metab 2012;16:679-80.  Back to cited text no. 3
    
4.
Rodriguez-Gutierrez R, Gionfriddo MR, Ospina NS, Maraka S, Tamhane S, Montori VM, et al. Shared decision making in endocrinology: Present and future directions. Lancet Diabetes Endocrinol 2016;4:706-16.  Back to cited text no. 4
    
5.
Kalra S, Priya G, editors. Glucocrinology. 1st ed. New Delhi: Jaypee; 2019.  Back to cited text no. 5
    
6.
Dossett ML, Fricchione GL, Benson H. A new era for mind-body medicine. N Engl J Med 2020;382:1390-1.  Back to cited text no. 6
    
7.
Demir E. The evolution of spirituality, religion and health publications: Yesterday, today and tomorrow. J Religion Health 2019;58:1-3.  Back to cited text no. 7
    
8.
Kalra S, Joshi A, Kalra B, Shanbhag VG, Bhattacharya R, Verma K, et al. Bhagavad Gita for the physician. Indian J Endocrinol Metab 2017;21:893-97.  Back to cited text no. 8
    
9.
Raveendran AV, Zargar AH. Diabetes control during Ramadan fasting. Cleve Clin J Med 2017;84:352-6.  Back to cited text no. 9
    
10.
Kannan S, Mahadevan S, Seshadri K, Sadacharan D, Velayutham K. Fasting practices in Tamil Nadu and their importance for patients with diabetes. Indian J Endocrinol Metab 2016;20:858-62.  Back to cited text no. 10
    
11.
Julka S, Sachan A, Bajaj S, Sahay R, Chawla R, Agrawal N, et al. Glycemic management during Jain fasts. Indian J Endocrinol Metab 2017;21:238-41.  Back to cited text no. 11
    
12.
Kalra S, Kumar A, Aswathy S, Shriraam V. Community endocrinology. Indian J Endocrinol Metab 2015;19:695-6.  Back to cited text no. 12
    
13.
Kalra S, Girdhar R, Sahay R. Green diabetology. Indian J Endocrinol Metab 2015;19:698-9.  Back to cited text no. 13
    
14.
Wellness endocrinology. Available from: https://www.youtube.com/c/WellnessEndocrinology/featured?disable_polymer=1. [Last accessed on 2020 Oct 03].  Back to cited text no. 14
    
15.
Kalra S, Das AK, Baruah MP, Unnikrishnan AG, Dasgupta A, Shah P, et al. Euthymia in diabetes: Clinical evidence and practice-based opinion from an international expert group. Diabetes Ther 2019;10:791-804.  Back to cited text no. 15
    
16.
Kalra S, Kapoor N, Kota S, Das S. Person-centred obesity care–techniques, thresholds, tools and targets. Eur Endocrinol 2020;16:11-3.  Back to cited text no. 16
    
17.
News. Available from: https://www.isendo.org/news/. [Last accessed on 2020 Oct 03].  Back to cited text no. 17
    
18.
Endocrine Society of India. Available from: https://www.endocrinesocietyindia.org/. [Last accessed on 2020 Oct 05].  Back to cited text no. 18
    
19.
Executive Committee. Available from: https://www.endocrinesocietyindia.org/ec. [Last accessed on 2020 Oct 05].  Back to cited text no. 19
    




 

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