Facing the Diabetes Epidemic — Mandatory Reporting of Glycosylated Hemoglobin Values in New York City

Publisher Website
Google Scholar
Abstract
The diabetes epidemic in the United States continues unabated, with a staggering toll in acute and chronic complications, disability, and death. The primary culprits are poor glycemic control over the long term and other major risk factors, such as hypertension, cigarette smoking, obesity, and elevated levels of cholesterol or blood lipids. Although physicians know how to treat diabetes in individual patients, overall progress against the epidemic requires widespread improvement in glycemic control, as underscored by the recent finding that intensive insulin therapy reduces the risk of cardiovascular disease among patients with type 1 diabetes.1 In 2005, an estimated 20.8 million persons in the United States, or about 7 percent of the population, had diabetes, although the illness had been diagnosed in only about two thirds of these people, according to the Centers for Disease Control and Prevention (see line graph ). Older people, blacks, Hispanics, and members of some other ethnic groups are disproportionately affected.