The sixth most common cause of death in the United States is diabetes. The disease diabetes can be caused by such risk factors as obesity, cigarette smoking, poor diet and lack of exercise. In New York City alone there are about 530,000 adults with diabetes. It is the fifth most common cause of death in that city. The New York City Board of Health approved a plan in December 2005 to make reporting of glyosylated hemoglobin values mandatory. The results are transmitted electronically to the Department of Health and Mental Hygiene in that city. Some of the information included and stored are the patients full name, birth date, address and the date the tests were completed.
This measure raises all sorts of questions as to whether the health departments were overstepping their boundaries and also about the confidentiality of patients. The New York City Health inspector, Thomas Frieden said “We have to get a better handle on what is really the only major health problem in the United States that is getting worse and getting worse rapidly.”
The information that is collected may be used to contact the patient with educational materials. Their physicians might also receive reports if the patient has skipped any follow up testing. According to Thomas Frieden, individuals with privacy concerns can simply opt-out of mailings. This does not remove their name from the central database though. The city does have a health code that prohibits anyone except the patient and their medical providers accessing the information.
In the United States the number of people with diabetes since 2006 has risen 13.5 percent. At the moment 57 billion Americans have blood sugar levels that put them at the risk for diabetes. This also increases their risk of Heart disease, stroke, kidney disease, blindness and nerve damage. At the rate that this is going 1 out of every 3 people born in 2000 will be in danger of getting the disease.
Because of these dire statistics diabetes experts assembled in New York City. Attendees from around the world discussed the different options and techniques to help patients lose weight and avoid the obesity epidemic. A suggested nonsurgical method is a gastric sleeve that works in the same way as gastric bypass surgery. Of course the gastric bypass surgery was also put forth as an option and then the still experimental method of an implanted smart gastric band that senses food in the stomach and knows when to tighten or loosen it’s grip.
Since diabetes now affects about 24 million Americans researchers need to find a way to help stop this epidemic. The way to do this seems to be heading it off in the first place. Preventing is still the best way to eradicate diabetes but getting people to make the exercise and dietary changes is difficult.
Although when neighborhoods and schools encourage healthy changes people seem to become more involved in adujsting their lifestyles.
Popular research from a large clinical trial conducted by the Diabetes Prevention Program Research Group gives us some interesting data. 3000 pre-diabetic adults were randomly into on of three groups. The first group was given a placebo. The second group was given netformin, an oral diabetes drug that lessens glucose production. The last group was told to use the original strategy of lifestyle changes. They had to adhere to a low fat diet and low calorie diet. They also had to engage in at lest 150 minutes of exercise every week. The members of this third group received behavior modification in personal counseling sessions once a week. The goal was to lose 7 percent of body weight.
The conclusions from this study indicated that the people in the third group lessened their risk of getting diabetes by 58 percent. In comparison the second group that took metformin only reduced their risk by 31 percent.
With weak public funding this approach well be available to a very few. Diabetes receives much less funding from the government than many other diseases. Insurance companies don’t like to pay out for patients with pre-diabetes but will usually help if the patient has type 2 diabetes.
With over 1.6 million adults diagnosed with diabetes last year this is truly an epidemic in progress.
