Over the past year, the Department of Health and Mental Hygiene of New York City has been collecting laboratory information documenting HbA1c levels of patients with diabetes. This information is then channeled back to doctors who are in charge of care of these residents. In addition, a one-time screening test is being conducted in order to estimate the prevalence of diabetes among approximately 2,000 randomly selected New Yorkers from 144 neighborhoods across all boroughs. The information from patients is stratified according to the HbA1c level – less that 7% representing “good control”, between 7% and 9% “poor control”, and over 9% reflecting “very poorly controlled” diabetes. The doctors receive the patient’s full name, date of birth, address, as well as the date and the facility where the test was taken. Although this information seems rudimentary, it may have a far-reaching impact on the way diabetes is cared for in this part of the country. Information is a very powerful tool, and given the right circumstances and the right attention, it may go along way towards prevention of complications.

Results from the screening test, are also remarkably interesting. In sum, NYC has more diabetes. Nearly 13% of the city’s adult population has diabetes, and almost 4% of residents, do not know it! Furthermore, an additional 3.8% of adults in NYC have undiagnosed diabetes, and a staggering 23.5% have prediabetes. When different ethnic groups in the city are evaluated, Asians come out first, then Blacks, followed by Hispanics, and then Whites. This wealth of information will serve the city well in setting up programs to better prepare for this “tidal wave”.

Data from the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) suggests a strong relationship between early (prepuberty and puberty) obesity in girls, and later (adult) cardiovascular complications. Girls between the ages of 9 and 12 years tend to be more overweight than later in life, and African American girls tend to be more so than their white counterparts. This translates to more hypertension, higher cholesterol, and more diabetes among African American young adult females, and ill bodes for their future. Why puberty is related to weight gain is not well understood, and why particularly in females, is even less so. Obviously, it may have something to do with the burst of sex hormones that is characteristic of this age group. But the true cause is likely more complex. We need to focus on the social/life-style issues that put these girls at risk, so that they can grow up and become a well adjusted and productive part of our society, and not a burden to themselves and to others.

An observational study conducted over several decades in the Iowa City area involving 653 formula-fed white infants, has described a relationship between rapid weight gain during the first week of life, and adult obesity. The median (average) weight gain during the first week of life in this study was 200 grams. After adjusting for multiple factors, the researchers found that for each 100 gram increase in weight, the risk of adult obesity rose by about 28%! This is important news, and should make us sensitive to overweight as being unhealthy from day one.

In Ukraine, babies born in spring were more likely to have diabetes type 1, than if they were born in winter. The reasons are unknown, but most likely are environmental, and complex. Apparently, this has previously been reported in other European countries, as well. Nutrition is a factor, since fresh produce tends to be seasonal. Consequently, the level of vitamins in the mother’s diet should be evaluated. Viruses more common in spring could possibly be the culprit for “jumpstarting” the immune system into attacking the beta cells. Regardless of the reason, a similar study needs to be done in the US.

In a large study involving 2,281 children, sleep behavior was followed and recorded. The researchers found “a large decline in weekday sleep across middle childhood and adolescence, driven largely by late weekday bedtimes”. The recommended sleep time for younger children is 10-11 hours. Researchers reported a significant and troubling decline in the recommended hours of sleep. Additionally, an association between increase in BMI (body mass index) 5 years later and lack of sleep, was also reported. In fact, 1 extra hour of sleep above average lowered the child’s risk of being overweight 5 years later – from 36% to 30%! The mechanisms responsible for this are yet to be described, but please take heed.

Governors from 11 states are currently involved in a request from the FDA to allow the manufacturing of generic insulin. This would help meet budget constraints of the respected states, and would also be helpful to many insulin-requiring patients. The process, however, is not simple – both scientifically and politically, and we may wait quite a while before the first generic insulin hits the market.

GlucoShot: This new product is a rapid-acting glucose liquid intended to treat hypoglycemia during exercise or sleep. Each GlucoShot tube contains 15 grams of glucose per 2-oz travel-size bottle without caffeine, sodium, or fat. The company is called Can-Am Care, and can be reached at 678-795-3440 or at www.canamcare.com.

Glucose Advocate: This is a voice-activation Medicare-approved glucometer designed for the vision-impaired diabetic. The meter will use a small blood sample (0.7ml), report result in 7 seconds, and will save 450 test results for up to 7-90 days. It is bilingual, as well. Information at 866-373-2824 or at www.pharmasupply.com.

Accu-Chek Travel Kit: This is a booklet with tips for travelers with diabetes, which includes all the information which is necessary for healthy traveling. Info at 800-858-8072, or at www.accu-chek.com.