Yesterday
For 15 years, NCAFP member Dr. Lenard Salzberg worked to create the American College of Diabetology (ACD). After helping found the college in 2021, Dr. Salzberg then became its chair in January 2025! The physician-led ACD trains and certifies primary care physicians to ensure high standards in diabetes care delivery and clinical diabetes management.
That was the year he attended the Coastal Carolina Diabetes Day at the East Carolina University (ECU) School of Medicine. The conference showcased the latest breakthroughs in diabetes care and introduced Dr. Salzberg to someone who became important to the eventual formation of ACD. “The late Dr. Robert Tanenberg, director of the diabetes fellowship at ECU, directed the conference and taught there,” Dr. Salzberg says. “I ate lunch with Dr. Tanenberg and his fellows, and he mentioned that there were only two diabetes fellowships in the country: at ECU and at the University of Ohio. Both fellowships started at the same time because there was an overwhelming need for people to take care of patients with diabetes. In Fayetteville, North Carolina, we had that need, too.”
Dr. Salzberg asked if Dr. Tanenberg would share his fellowship’s curriculum, so that he could explore setting up a diabetology fellowship at the Southern Regional Area Health Education Center (SRAHEC) in Fayetteville. Dr. Tanenberg shared his materials, and Dr. Salzberg prepared a proposal for the fellowship in 2007. But it would have to wait. “Our CEO at the time told me that the timing and the money weren’t right, and so we’d have to put it on hold,” Dr. Salzberg says.
He waited until 2014, when a new opportunity again opened the door to diabetology training at SRAHEC. That’s when a nurse practitioner named Marilyn Wilson asked Dr. Salzberg to supervise her and her work with patients with Type 1 diabetes on insulin pumps. That’s how they began working together.
The one-year fellowship began in August 2015 when Dr. Salzberg was SRAHEC residency program director. The fellowship was similar to the ECU fellowship and offered a rigorous curriculum to graduates of Family Medicine residencies. Dr. Salzberg says the fellowship came just in time. “The number of patients with diabetes was booming,” he says. “As they aged, they were getting type two diabetes. But then the number of endocrinologists was decreasing, as fewer medical students went into that specialty.”
While leading the fellowship in 2018, Dr. Salzberg encountered a diabetology fellowship director named Dr. Jay Shubrook. Dr. Shubrook led the fellowship at Touro University in Vallejo, CA. He told Dr. Salzberg he wanted to collaborate: “At the time, there were only five diabetology fellowships in the U.S.,” Dr. Salzberg says. “Jay suggested that we fellowship groups start meeting monthly to discuss our commonalities, our differences, and how we could collaborate.” The fellowships did just that, beginning with monthly Zoom calls. Not even the COVID-19 pandemic could slow down the collaboration that had started. In 2022, they decided to form the ACD, and Dr. Salzberg helped found the ACD board with ten other leaders. “Our goal was to support each other and have a formal mechanism to recognize this training we were doing,” Dr. Salzberg says.
In January 2023, the ACD received a $2.99 million grant from the Helmsley Charitable Trust. With that funding, it granted $150,000 each to six new fellowship programs. “That more than doubled the number of diabetes fellowships in the country,” Dr. Salzberg says. He adds that results of these new fellowships came that same year: “22 physicians passed the first ACD Board exam in 2023 and are now board-certified diabetologists.”
Now that he serves as its chair, his work with the organization has only become busier since 2023. “We will award three more grants this coming year,” he says. “We have also begun a process of accrediting the fellowship programs. Our mission is to uphold high standards, competent care, and effective clinical management by training clinicians to do those things. We’re writing a curriculum for medical students and for residents, while also training clinicians directly.” The ACD currently has 39 board-certified diabetologists and over 200 members, and in September it will host its third annual meeting in Denver, CO.
Such a national effort requires a lot from Dr. Salzberg. But he already had exposure to an organization where he could learn. “Being an Academy member helped me by having me go to national meetings and see how this can be done on a big scale,” Dr. Salzberg says. “Together with the Society of Teachers of Family Medicine, it helped me envision what the ACD should become.”
Congratulations to Dr. Salzberg on a great start to the critical work he and others began nearly 20 years ago!
The North Carolina Academy of Family Physicians, Inc. (NCAFP) is a nonprofit professional association headquartered in Raleigh which represents over 4,300 family physicians, family medicine residents, and medical students across the state. It is the largest medical specialty association in North Carolina and is a constituent chapter of the American Academy of Family Physicians, based in Leadwood, KS.