Growing up in the West African country of Cameroon, Justin Echouffo Tcheugui always knew he would be a doctor. Or a lawyer. Or an engineer. “Actually, I wanted to do political science, but my mom didn’t really like it,” he laughs, “because where I come from there are three acceptable jobs. Doctor, lawyer, engineer.” His parents were both academics, his mother a French teacher, his father a psychologist, and there was an expectation for Tcheugui to succeed in school. Still, when he was not studying, he would gather with the neighborhood kids to play soccer in the sunny streets of Yaoundé.
Tcheugui eventually found his way to medicine. He earned his medical degree from the University of Yaoundé, and while his thesis focused on cysticercosis and epilepsy, his initial interest had been diabetes. “I had a cousin who died very young from diabetes complications,” he says. “I planned to research diabetes-related neuropathy in a rural part of Cameroon, but it didn’t pan out.”
Soon after medical school, Tcheugui made his way to the University of Cambridge. “Everything crystallized for me there,” he says. He began to work on diabetes under Simon Griffin and Nick Wareham at Cambridge’s Medical Research Council Epidemiology Unit.
“Wareham integrated everybody,” Tcheugui says. “He was known at Cambridge for working with everyone, especially with Africans—he was one of the few people in the noncommunicable disease department to work with people of all nationalities.”
Tcheugui is now associate professor of medicine and associate director for student and resident education in the Division of Endocrinology, Diabetes, and Metabolism at Johns Hopkins School of Medicine. His research is focused on the early detection of diabetes, and he specializes in diabetes prevention, prevention of complications, and understanding the links between diabetes and cardiovascular disease.
“It became obvious to me that one of the main reasons that one treats diabetes is to prevent cardiovascular disease,” he says. “We usually talk about retinal and kidney disease, but I think it’s much more important to prevent cardiovascular disease. My sense these days is that if one can prevent obesity, one will ultimately prevent diabetes, and ultimately prevent cardiovascular disease.”
Two factors play key roles in the onset of obesity: diet and physical activity. However, individual motivation is only part of the puzzle.
“Even if you want to be physically active, do you have the resources to do so?” Tcheugui says. “Do you live in an environment with access to gyms? Is there a nearby park to run? If you cycle, do you have bike lanes? Then in terms of dietary choices, food deserts are a reality. All of this is beyond the control of the individual.”
With the growing rates of youth-onset type 2 diabetes, it is also important to establish healthy habits at an early age.
“If people are used to eating certain things early in life, they will be inclined to continue those choices all along,” Tcheugui says. “Same with physical activity. Children should be prompted and encouraged to have enough physical activity. If this can’t happen informally, it should happen more formally.
“I tell my kids this all the time,” he adds. “Swim lessons, dance lessons, basketball—we didn’t need to organize these things when I was young. When we had free time, we went outside, we played soccer, we improvised.”
