Butler Health System cook Sara Spangler prepares veggies at Butler Memorial Hospital on Friday. Eating right is one key to keeping diabetes under control.

With the recent addition of two staff endocrinologists to Butler Health System's staff, the area is better positioned now than at any time in recent memory to confront issues like obesity, diabetes and the various conditions that can manifest as a result of those issues.

Endocrinologists Dr. Sanjay Dixit and Dr. Emily Martin joined BHS in mid-2016, and their arrival marked the revival of a long-defunct program within the hospital system.

Endocrinology is the study of hormones, and doctors like Dixit and Martin are focused on issues such as obesity and diabetes — two intertwined conditions with which Butler and the entire country are struggling, Dixit said.

“I wouldn't say that diabetes is more prevalent in Butler,” Dixit said. “But maybe there's less access to care, or good care. So we see a lot of poorly controlled diabetes.”

Patients who struggle to keep their diabetes under control — eating right, exercising and sticking with a medical treatment regime, depending on what type of diabetes you have — can be at risk for short- and long-term complications that range from hypoglycemia, or low blood sugar, to eye, kidney and nerve disease.

Martin said much of what the pair does every day is work with patients to try and prevent — or even reverse — the diabetes' progression. For a patient with Type 2 diabetes, she said, a change in lifestyle can have dramatic effects. For those in the early stages, Martin said, losing weight and changing their diet can even sometimes put the disease into remission.

“Diet, exercise and sleep — especially in those early stages, can be really effective for at least stopping the progression of the disease,” she said.

While Butler's struggles with obesity and diabetes aren't extraordinary, Dixit said, the problem most recently has been patients' inability to get care locally.

Dixit and Martin both came to BHS in mid-2016, after training together from 2009 to 2011 and then working as attending physicians. Dixit previously worked at UPMC and Martin at the Veterans Affairs system in Pittsburgh.

“This opportunity had not been filled for a long time, and we both wanted to make an impact in the community that was definitely needed,” Martin said.

When they arrived at BHS, the need for an endocrinology department in the system was apparent, Dixit said. The pair initially faced a surge in patient demand that created a two-month-long waiting list.

That backlog has now been dealt with, Dixit said, and the pair are now able to focus on additional issues, like what had been a hole in the hospital system's treatment matrix for patients with overactive thyroid or thyroid cancers. Plugging that hole with radioactive iodine treatment — something that can shrink a person's thyroid gland and is considered a reliable treatment for hyperthyroidism — is something that will help keep patients within the BHS network, and increase the likelihood of them receiving follow-up care, the doctors said.

“I think if you can keep everything in the same medical system, it makes everything easier,” Dixit said. “If you send them 50 miles away for something they don't see as an immediate (problem) there's no guarantee that they'll go.”

Keeping the services within the system also helps patients and doctors.

“If you can have it all in one place it really benefits the patient,” Martin said.

In the future, Martin and Dixit say they want to focus on an obesity management program that can help diabetes patients and others combat one of the biggest public health problems in the country.

“That truly is the epidemic nationwide,” Dixit said. “And that's what we're talking about all day every day.”

Martin said the pair also wants to focus on some gender-specific issues like polycystic ovarian syndrome, which is essentially a prediabetic state that puts women at higher risk for things like cardiovascular disease.

“I think we're learning more and more about obesity,” Dixit said. “It's not just a math problem where patients eat less and exercise more and there's some magical formula. Everybody's different.”

Martin said one of the other hurdles facing endocrinologists and patients struggling with weight issues is that medical treatments for weight issues often aren't covered by health insurance plans.

That state of affairs has begun to improve over the last five years or so, but there's progress yet to be made.

“The paradigm is changing, but it's not quite there yet,” Martin said.