HOLLI W. HAYNIE

Dr. George Burghen examines a patient

For more than 40 years endocrinologist Dr. George Burghen has been dedicated to the mission of understanding and preventing diabetes. As chief of the department of endocrinology and metabolism at Le Bonheur Children’s Medical Center, Burghen and his small team shoulder a tremendous responsibility in combating the obesity epidemic.

“My major interest is working with pediatricians and family physicians in helping them develop programs in their office to take care of the obesity epidemic in our community,” Burghen said. “We just see a few new patients each week. There is no way in the world a small number of doctors can take care of the problem.”

It is estimated that more than 110,000 children in the Mid-South area are overweight or obese.

Burghen works daily with patients in his lifestyle clinics to help families develop strategies to improve their nutrition and overall health. In order to address childhood diabetes and obesity on a larger scale, he developed prevention, evaluation and treatment methods and guidelines physicians can use in their office.

He and his team created a tool kit for doctor’s offices essentially because they have the opportunity to address more children daily. The kit, which Burghen spent 18 months writing, includes 19 pages of forms and documents with a simple, systematic approach to developing a healthy lifestyle program and basic guidelines that can make the task of diabetes and obesity prevention less cumbersome. It’s designed to be user friendly and straight forward for doctors and parents to monitor and address diet, exercise, sleep and health conditions.

A few years ago Burghen sent out the tool kits to a couple hundred local physicians but funding, physician self-efficacy issues and the enormous task of dealing with the epidemic while being understaffed continue to impede a widespread impact. In addition Le Bonheur is actively seeking pediatric endocrinologists to help their case load yet with a shortage of these physicians across the country, it makes prevention seem all the more monumental. But Burghen and his staff are working hard to attract the medical community bit by bit to become involved in the prevention effort and requires the involvement of multiple subspecialties. Burghen and his team have presented their tool kit to the Tennessee Medical Association and given seminars in and out of state in an effort to spread awareness and garner additional support for a community, state and even region an nationwide adoption of the kit.

“To build the masses to do the work you have to involve physicians across the board, including sub specialists,” Burghen explained.

Through the years Burghen has contributed to many studies and published more than 250 articles, abstracts and book chapters on insulin degradation, treatment of diabetic ketoacidosis in children, insulin resistance in polycystic ovarian disease, pancreatic islet isolation, and psychosocial interventions in type 1 diabetes. He was also part of the massive Diabetes Control and Complications Trial (DCCT) which confirmed hyperglycemia as the cause of diabetic complications, effectively changing the way diabetes was treated.

He has been a long time member, volunteer and served on the national board of directors for the American Diabetes Association. Burghen and his team were also instrumental in changing the law on nutrition standards in Tennessee schools which went into effect last year, requiring all schools to adopt a wellness plan to improve lunchroom nutrition and eliminate sodas and junk food from the vending machines.

One of his biggest challenges is changing the perception of obesity prevention in the medical community. Some physicians are reluctant to use obesity intervention measures because of a lack of definitive information on outcomes. Statements like that give by the U.S. Preventive Services Task Force which recommended against primary care providers screening for overweight in children to prevent obesity, explained Burghen, has caused patients and physicians to release the burden of responsibility for poor treatment outcomes. He said community and school based interventions are proven to be effective, but the application of such interventions are problematic due to cost, logistics and experience of those involved.

“Just sitting back and doing nothing doesn’t help,” he said. “I can tell you that most interventions, no matter what it is, will help at least a third of the people that you’re trying to help.”

Plus, he said, he figures they help about two thirds of the people who come back after failing. Typically people are unsuccessful in interventions because they don’t carry out the recommendations. It’s not the intervention that doesn’t work, maintained Burghen, but non compliance that causes failure.

“The people that do what we tell them to do, pretty much across the board, are successful,” he added.

Ultimately his diabetes prevention concept could work if physicians realized their greater role in advocating intervention methods.

“My concept is for them to go through this, get the data they need to see if the kids have diabetes or pre-diabetes, then send the children to a center where they are educated with the parents,” he said.

For treatment of obese children at Le Bonheur, Burghen has lifestyle classes where families can learn about the obesity epidemic and the various genetic and environmental factors that play a role in creating and exacerbating the condition.

Burghen has also begun working with a new glucose sensor which records and reports blood glucose levels at five minute intervals for three days. He hopes it will control blood glucose, thereby preventing or reducing diabetic complications.

One of his favorite commitments is diabetes camp. He’s been involved with various camps since 1971 and continues to sponsor a two-week summer diabetes camp at Camp Hopewell in Oxford, Mississippi where children learn about their diabetes and meet other children with diabetes.

“My number one passion,” Burghen concludes, “is to help children and their families take care of their diabetes and live as normal a life as possible.”



November 2007