Doctors have proposed to reform the system of treatment of chronic diseases
The modern healthcare system, divided into narrow specialties, cannot cope with the treatment of patients with a set of interrelated pathologies such as obesity, type 2 diabetes and heart failure. The need to create a unified cardiometabolic discipline is reported in The Lancet magazine.
The researchers note that now a person with overweight, kidney and heart diseases is forced to visit five different clinics and receive conflicting recommendations. At the same time, all these conditions develop along common biological pathways associated with insulin resistance and inflammatory processes.
According to the study, fragmentation of medical care leads to an increase in the burden on the healthcare system: according to a study from the United States, every 0.1 units of the index of separation of care for diabetics increase the number of visits to emergency departments by 15%.
The authors of the material emphasize that coordination of actions of different doctors alone is not enough. Even interdisciplinary consultations do not resolve the issue of personal responsibility for the overall well-being of the patient. As a solution, it is proposed to introduce a specialty of cardiometabolic medicine by analogy with geriatrics, which evaluates the state of the body in a complex.
In 2026, the American medical community has already taken a step in this direction by issuing guidelines that combine risk factors for cardiovascular disease, kidney disease, and metabolic disorders. However, experts insist on forming a full-fledged knowledge base and competencies so that a patient with obesity or liver steatosis can receive one linked treatment plan instead of several disparate directions.
The publication acknowledges that most patients do not need another doctor's appointment — they need fewer decisions, but more responsibly. At the same time, the editorial board of the scientific journal recognizes the risks of creating a new discipline, including possible bureaucratization and territorial disputes between medical colleges. Nevertheless, the rapid increase in the number of metabolic diseases requires a review of the organization of medical care at the current moment.
Invitro gastroenterologist Olga Patyukova, in an interview with Izvestia on June 25, spoke about a possible link between microbiota imbalance and obesity and diabetes. According to the expert, the microorganisms of this system are involved in the breakdown of complex carbohydrates, the synthesis of short-chain fatty acids and vitamins, help digest food, protect against pathogenic bacteria, support the immune system, and also affect human mood and behavior.
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