An unprecedented program of tracking people with diabetes through their blood sugar tests has been launched in New York City. This is a procedure that is normally reserved for infectious diseases that pose a risk to others.
Statistics show that in New York City, the percentage of people with diabetes is one-third higher than in the rest of the U.S. This has been attributed to the large population of poor and obese people who are at higher risk for diabetes.
The city's health commissioner, Dr. Thomas Friedan, who is spearheading the program said, "We're in the middle of an epidemic, an epidemic of diabetes killing people. It's causing blindness, kidney failure, amputations. We need to do what we can do to help people get the best possible care."
Under the program, labs are required to forward test results to a central database, where their blood sugar levels are monitored. If their blood sugar levels get too high, public health officials are supposed to contact the patient and alert them of the need for prod better control of their diabetes.
According to Medical ethicist Lawrence Gostin, a law professor at Georgetown University in Washington, D.C., he supports the program but wonders if others will see it as the government acting as a nanny state.
He said, "This is seen by many people as quintessential government intrusion on the private lives of individuals."
"The public health official knocks on your door, says, 'Well you realize your blood sugar is very high,'" said Gostin. "Have you been taking your medications? Have you seen your doctor?"
Besides he expressed concerns of patients viewing this program as an invasion of privacy.
Gostin said, "There are some people who think that medical information is simply between me and my doctor. No one else has the right to know."
Patients who partially opt out of the program will not be contacted by the health department but all test results will be entered into the database.
Scott Strumello, who has dealt with Type 1 diabetes most of his life said that the program ignores the real reason some New Yorkers can't control their diabetes which is a lack of health insurance.
Strumello, who said he watches his blood sugar levels like a hawk said, "Patients should be able to make a choice for themselves as to what works best for them. To have somebody tell you probably isn't going to work. There's a lot of clinical evidence to suggest that."
Several public health agencies are watching the New York program closely mainly because of the exploding rates of Type 2 diabetes rates across North America and worldwide.
The city aims to show at least a 20 per cent decrease in severely uncontrolled diabetes by 2008.