The new study includes other concerning findings as well. Some 500,000 New York City adults have been diagnosed with diabetes; 200,000 more have the condition but don’t know it. In addition, the new study suggests that 1.4 million non-diabetic New Yorkers have high enough blood sugar levels to place them at high risk of developing diabetes. This high rate of “pre-diabetes” is a forecast for a huge wave of future illness.

New York City, like many urban communities, has a higher concentration of poverty than the rest of the nation. The city also has greater racial/ethnic diversity, resulting in a larger proportion of people at a high risk of developing diabetes. The Health Department’s study found that adults making less than $20,000 a year were almost twice as likely as higher-income adults to have diabetes (15.7% versus 8.9%). Black New Yorkers were at higher rates than whites (14.5% versus 10.7%). And Asian New Yorkers had the highest rates of both diabetes (16.1%) and pre-diabetes (32.4%), despite having lower rates of overweight (according to the body mass index).

In New York City, more than 80% of people with diabetes are overweight or obese. Reversing the obesity epidemic requires action on many fronts, including reducing consumption of soda and other sweetened beverages – a major contributor to weight gain and the growing diabetes problem. In a study published last spring in the Journal of Urban Health, Health Department researchers reported that 27% of New York City adults consume one or more sugar-sweetened sodas each day. The frequent soda drinkers consumed an average of nearly two cans – or 300 extra calories – every day. The biggest soda consumers were Black and Latino New Yorkers, people with less than a college education, and those from low-income households – the same people at highest risk of diabetes.

For people who have diabetes, controlling the ABCS – A1C (blood sugar), blood pressure, cholesterol and smoking – is critical to staying healthy. Yet the new study, based on data from the 2004 NYC Health and Nutrition Survey, found that half of people with diagnosed diabetes had elevated blood pressure and nearly two thirds had high cholesterol. Many had not been prescribed medications for either condition, and only 12% were on insulin – compared with 23% nationally. This lack of treatment suggests that many of New York City’s medical institutions are failing to meet nationally recognized standards for managing diabetes.

The new study stresses the need to create environments that foster healthy eating and encourage physical activity. Chronic disease is common in settings where junk food abounds, fresh produce is scarce, and opportunities for physical activity are lacking. Conversely, environments that encourage exercise, discourage smoking and provide better food choices can improve people’s health. Physical activity and nutrition programs have been shown to reduce the progression to diabetes in those at highest risk by 60%.

In 2004, New York City implemented its first community-level Health and Nutrition Examination Survey (NYC HANES). From June through December 2004, a population-based, cross-sectional examination survey was conducted with non-institutionalized New York City adult residents, age 20 or older. A sample of adult residents underwent a detailed health interview and brief physical exam. During interviews, the department determined previously diagnosed diabetes. Researchers then measured fasting plasma glucose in a probability sample of New York City adults to gauge the prevalence of undiagnosed diabetes, and of pre-diabetes.

New York City Health Department - Wed, 12/31/2008

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DID YOU KNOW: 
85% of Type 1 Children are Vitamin D Deficient: Three-quarters of children and adolescents with type 1 diabetes had insufficient levels of vitamin D in a study conducted by researchers at Joslin Diabetes Center.The findings suggest that children with diabetes may need vitamin D supplementation to prevent bone fragility later in life.   Twenty-four percent of children and adolescents had sufficient vitamin D levels, 61% had insufficient levels and 15% were vitamin D deficient. Generally, patients with deficient levels were older. In total, 85% of the children and adolescents had inadequate vitamin D levels.  See This Weeks’ Item #7