SUMMIT TWP — The newest medical practice with Butler Health System opened Monday at Suite 101, 127 Oneida Valley Road.

Already Dr. Emily Martin and Dr. Sanjay Dixit have a full schedule of appointments booked to the end of August.

Before coming to Butler Memorial Hospital, Martin worked in the VA Pittsburgh Healthcare System.

Dixit was at the University of Pittsburgh Medical Center.

They knew each other from their endocrinology training.

Martin said endocrinology was a specialty that the Butler Health System needed and wanted.

“It’s a service that any hospital should offer,” Dixit said.

“We deal with all types of disorders that involve hormones — overactive and underactive thyroid, pituitary and adrenal problems, bone problems including osteoporosis and other rare bone disorders (and) problems of calcium metabolism,” Dixit said.

These conditions usually would be noticed by a primary care physician before the patient sees Martin or Dixit.

They also expect at least 50 percent of the people they see in their practice will have diabetes.

According to Dixit, data from 2012 for Butler County is similar to the state figures; about 11 percent of people age 20 and above know they have diabetes.

“Nationwide and even worldwide, the prevalence of diabetes is increasing steadily,” Martin said. “It has been estimated that by 2020, up to one in four adults will be diagnosed with diabetes.”

“Not all diabetics need to come to endocrinology,” Dixit said. “Primary care doctors are trained to treat diabetes.”

Martin said endocrinologists usually work with patients who need more complex care and whose blood glucose is not well controlled. They also work with those who need more attention and education, who have many side effects of medications and who have complex medical regimens.

Martin said diabetes is an impairment of glucose, or blood sugar, metabolism.

According to the American Diabetes Association, cells in the pancreas make the hormone insulin. These cells release insulin to help the body use or store glucose it gets from food.

In type 1 diabetes, the pancreas produces little or no insulin. The pancreas of someone who has type 2 diabetes either doesn’t supply insulin or what it does supply isn’t used efficiently. The result: high blood glucose levels.

Martin said, “We do know (type 1 diabetes is) an autoimmune process.”

She said the immune system attacks bacteria and viruses. In an autoimmune disease, the immune system attacks normal body tissue. The body’s immune system doesn’t recognize part of itself.

Dixit said researchers are investigating type 1 diabetes as an autoimmune disease where clusters of cells in the pancreas are destroyed. Dr. Martin said this is a hot topic of research.

“Poor diet and weight gain contribute to the development of type 2, which is not an autoimmune disease. Type 2 is basically insulin resistance,” he said.

“It’s not using the insulin properly,” Martin said.

They said lifestyle choices contribute to the development of diabetes, for example, lack of exercise, poor diet, weight gain, lack of sleep and stress.

“Not everyone who eats poorly and doesn’t exercise gets diabetes,” Dixit said.

“There is a large genetic predisposition as well,” Martin said.

Dixit said there is no evidence that bacteria or viruses cause type 2 diabetes.

The American Diabetes Association website at www.diabetes.org lists common symptoms of diabetes including urinating often, feeling thirsty, feeling hungry even though you are eating, extreme fatigue, blurry vision, cuts and bruises that are slow to heal, weight loss even though you are eating more, and tingling, pain or numbness in the hands or feet.

The two doctors said if a person has these symptoms, he should see a primary care physician and ask to be tested for diabetes.

“We prefer them to go through their PCPs so they can get through some preliminary tests,” Martin and Dixit said.

They said, “It’s not just a number that we’re treating. There are complications that we are trying to prevent.”

“When there is untreated or poorly managed diabetes you are at a much higher risk of complications of blood vessels,” Martin said.

She said for large blood vessels complications would be coronary artery disease and stroke.

“For smaller blood vessels it would be eye disease, kidney disease and neuropathy or the numbness and tingling and loss of sensation,” Martin said.

Lindsay Stewart, a physician’s assistant, will be at the new office with the doctors. She also practiced at UPMC.

“As part of our office we have certified diabetes educators — sort of like one-stop shopping,” Martin and Dixit said.

The doctors might have stayed in Pittsburgh but they came to Butler instead.

Martin said, “It’s a great community — a small town feel but a great medical facility where we can offer great care ...”

“ ... but in a more personalized environment.” Dixit said.