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Diabetes Bites the Big Apple

New York City is facing an epidemic of diabetes, new figures showing that nearly 8 percent of adults in the city have the disease, double the rate of eight years ago.

This rate, which mirrors national trends, is particularly high in the city's poorest neighborhoods, where obesity rates are also extremely high, according to data collected
by the city's Department of Health in a study last spring of 10,000 New Yorkers that the department says is the largest health survey ever conducted in the city.

For example, the study found that in East New York, Brooklyn, more than 31 percent of the residents are obese, and 13 percent have diabetes. In the South Bronx, 27.3 percent are obese and 13.9 percent have diabetes. The disease was least prevalent on the Upper East Side, where less than 2 percent of residents are diabetic, and only 7 percent are considered obese.

Last year, diabetes was the sixth-leading cause of death in New York City, although city health officials said that the number of people who die from diabetes is probably underestimated.

In the city, 12.2 percent of Hispanics have diabetes, as do 10.8 percent of non-Hispanic blacks. Whites who are not Hispanic have the lowest rate - 5 percent - and Asians are
second to last, with 6.8 percent. The Bronx leads the city in diabetics, with 11.5 percent of residents having the illness, while 4.6 percent of Staten Island residents have it.

Dr. Frieden has made addressing chronic diseases a focus of his department since
he was appointed last year. Health Department officials said that  nearly 80 percent of New Yorkers with diabetes are overweight, the study found.

Nationwide, 7.8 percent of adults have diabetes, and that rate has also doubled in the last several years.

Perhaps more alarming, between one quarter and one half of children nationwide with diabetes have Type 2 diabetes, which is often related to obesity, according to Dr.
Kaufman, who is also an endocrinologist at the Children's Hospital of Los Angeles. New York health officials estimate that in the city the rate is closer to 50 percent.

City officials were startled to see that many doctors in private practice and in city hospitals fail to manage the care of diabetics, and do not do basic things like take regular blood-sugar readings of their patients. For instance, only 15 percent of respondents in the study with self-reported diabetes knew their blood-sugar level. This has led researchers to conclude that thousands of New Yorkers are at risk for developing serious complications, many of them potentially life-threatening, like heart disease, kidney failure and problematic pregnancies.

Dr. Frieden said that the city would take aggressive steps to educate city doctors and hospital workers about diabetes management, and would begin by pushing the public hospitals to get certified in special diabetes-management techniques,as other hospitals in the nation have done. While studies show that even modest weight loss and increased exercise can greatly reduce the symptoms of Type 2 diabetes, Dr. Frieden said, it was more realistic to focus on managing the disease then on pushing people to lose weight.

He did say, however, that his office would try to encourage doctors, especially pediatricians, to educate their patients about suitable body weights.

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