On the high prevalence of type 2 diabetes in the U.S.

I want to call another newsworthy report to your attention. In today’s New York Times (page A21), an article by Richard Perez-Pena detailed the results of a study released yesterday on the prevalence of diabetes in New York City. This study, started in 2004 by the New York City Department of Health and Mental Hygiene, found that about 1 in every 8 New Yorkers have diabetes and many more have “prediabetes,” a condition in which people have abnormally elevated blood sugars, but not high enough to earn a diagnosis of diabetes; prediabetes is a very high risk precursor to the “real deal.” Anyway, the data suggest that more than 100,000 New Yorkers have diagnosed diabetes that is “seriously out of control,” and more than 200,000 don’t even know they have the disease. The city health commissioner, Dr. Thomas R. Frieden put it bluntly: “This confirms that we as a society are doing a rotten job both preventing and treating diabetes.” Who could disagree?

Actually, the data are not a great surprise; we already know that the prevelance of type 2 diabetes in the U.S. is about 10%- much higher in certain ethnic groups. In people over 40, the prevalence is about 11%; in people over 60, it is more than 20%. Amazing stuff. We will come back to this subject later, when we discuss the obesity epidemic- oh, I forgot to say, virtually all of the people with type 2 diabetes are overweight. Sorry.

I do want to congratulate the New York City Department Of Health and Mental Hygiene for their impressive work in documenting the alarming state of diabetes in New York (and everywhere else in the U.S.).

The good news with this bad news is that right now on January 31, 2007, we can both dramatically decrease the prevalences of prediabetes and diabetes and improve diabetes care, once the condition is diagnosed, but only if we as a society decide it’s important enough to do (it is). Later, we’ll discuss how to do things better- I promise. What does any of this have to do with pediatric endocrinology? Glad you asked. We are seeing MUCH more type 2 diabetes in children these days (not much before the teen years), generally in the same families where parents and other adult relatives have diabetes too. Of course, the children with diabetes (and prediabetes) are overweight, just like the adults.

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