New York City has launched an unprecedented program to track people with diabetes through their blood sugar tests.

Tracking people is a measure normally reserved for infectious diseases that pose a risk to others.

New York City faces a diabetes epidemic, said Dr. Thomas Frieden, the city's public health commissioner.
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In New York City, the percentage of people with diabetes is one-third higher than in the rest of the U.S. The city harbours a large number of people who are poor and obese, putting them at higher risk for diabetes.

"We're in the middle of an epidemic," said the city's health commissioner, Dr. Thomas Friedan, who is spearheading the program, "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 must forward test results to a central database, where they are monitored. If blood sugar levels get too high, public health officials may contact the patient and prod them to better control their diabetes.

Scott Strumello is a Type 1 diabetic who said he checks his blood sugars regularly.
(CBC)

Medical ethicist Lawrence Gostin, who is also a law professor at Georgetown University in Washington, D.C., says he supports the program but wonders if others will see it as the government acting as a nanny state. 

"This is seen by many people as quintessential government intrusion on the private lives of individuals," said Gostin.

"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?"

He is also concerned that patients may view it as an invasion of privacy.

"There are some people who think that medical information is simply between me and my doctor. No one else has the right to know," Gostin said.

If patients partially opt out of the program, the health department won't contact them but all test results will be entered into the database.

The program ignores the real reason some New Yorkers can't control their diabetes — lack of health insurance, said Scott Strumello, who has dealt with Type 1 diabetes most of his life.

"Patients should be able to make a choice for themselves as to what works best for them," said Strumello, who said he watches his blood sugar levels like a hawk. "To have somebody tell you probably isn't going to work. There's a lot of clinical evidence to suggest that." 

With Type 2 diabetes rates exploding across North America and worldwide, many public health agencies are watching the New York program closely.

By 2008, the city aims to show at least a 20 per cent decrease in severely uncontrolled diabetes.