Millions of dollars are spent every year in Bermuda treating diabetes and yet there is no physician diabetes specialist on the Island.

But that is about to change as Bermudian endocrinologist-in training, Annabel Fountain hopes to soon help tackle the problem of diabetes in Bermuda.

She is currently finishing her training at Chelsea and Westminster Hospital in London, England, in the Beta Cell Unit, (diabetes centre) and hopes to set up shop in Bermuda as a diabetes specialist physician next year.

"Since I have been learning under the British National Health Service (NHS) system, moving back to Bermuda will be a change," Dr. Fountain told The Royal Gazette.

"I picked endocrinology — the umbrella of my speciality, because I really liked it," she said. "I find it fascinating, challenging, and rewarding. There is a bonus, because it is really needed in Bermuda."

Although there is no endocrinologist diabetes specialist working in Bermuda, Debbie Jones is a certified diabetes nurse and founder and past president of the Bermuda Diabetes Association.

"With diabetes being such a major health threat, having an endocrinologist on the Island would help change outcomes," Ms Jones said. "An endocrinologist has the knowledge and expertise to diagnose complications and intervene to delay or prevent complications.

"An endocrinologist would assist in shaping health policies that would affect outcomes. Having a physician advocate for diabetes means that patients would have their best interests looked after."

Diabetes is a lifelong condition where the body does not produce enough insulin, or cannot use the insulin it produces. The body needs insulin to change the sugar from food into energy.

Long-term complications can include damage to blood vessels, kidneys, and difficulties with circulation.

Diabetes is the leading cause of adult blindness, kidney failure, and non-traumatic amputations of the feet and legs. It doubles to quadruples the risk of heart attack or stroke. It can lead to disability and premature death.

Dr. Fountain added: "Bermuda deserves better. Physicians do their best, but diabetes control in Bermuda probably could do a lot better. I know some people go overseas for diabetes care."

She said she had a lot to bring to the table, and hopes to deal with the more challenging cases.

"I think that is where I should point myself," she said. "Diabetes is not one hundred percent, but quite significantly preventable.

"If you care for it very well at the beginning of the disease, and take it seriously and you change your lifestyle you can prevent the complications.

"If you have had ten years of poor control, then tightening up later doesn't really get rid of the damage that has already been done."

But she said diabetes wasn't a choice.

"A lot of people have it in their family," she added. "People sometimes expect that they are going to get diabetes, but I don't think that people should have that expectation.

"They can make some choices in their life to avoid it, or have it not be so severe if they do get it."

She praised the Bermuda Diabetes Association for its work on educating the public about the condition.

"Getting rid of vending machines in schools is a great idea," she said. "We need to have a positive impact on lifestyle from a young age.

"Bermuda should find diabetes control in terms of the overall population easier to achieve than the United States. Bermuda has a small community that you can educate reasonably easily."

Dr. Fountain was among a group of world renowned panelists at a recent diabetes conference hosted by The Bermuda Diabetes Association in collaboration with the Bermuda Heart Foundation.

Nine experts talked on a range of diabetes-related topics such as diabetes and pregnancy, diabetes and heart disease, knowledge of the newest treatment paradigms and world policy development.

She said the conference, organised by Ms Jones, was a huge step forward. "We are really lucky that we have this conference," she said. "The people who come are absolutely world class. They have no reason to come here. They come as a huge gift to Bermuda."

She said some treatment centres were rethinking their approach to patient diabetes control.

"There is new data about how to get people to achieve good control," she said. "Obviously, it is very difficult for some patients to attend appointments frequently.

"They come maybe every couple of months to have their medications readjusted. We adjust something, and then they go away.

"You can give people written instructions as to how to adjust their own dosages. They can do it themselves and can achieve better control more quickly than if they were relying on the hospital appointment. That is really important."

She said this approach meant relinquishing some control as a doctor.

"I think we should be able to give up some of the control to our patients if they are perfectly capable of making decisions," she said.

Speakers at the conference were: the highly esteemed Oxford University Professor and director of clinical research Rury Holman; Dr. Neil Munro from the Beta Cell Centre at the Chelsea Westminster Hospital in London; Dr. Colin McIntosh author of the book 'Coming to Terms with Diabetes'; Professor Anne Dornhorst, a leader in the field of gestational diabetes (diabetes during pregnancy) ; Anne Felton, a nurse and president of the Federation of European Nurses in Diabetes (FEND); Dr. Ben Scirica, Harvard University instructor; Dr. Ariel Zisman, a Harvard trained endocrinologist in private practice in Miami; and Dr. Bruce Bode past president of the Georgia Affiliate of the American Diabetes Association.