SUNY Downstate Medical Center, N.Y.

— -- SUNY DownstateSUNY Downstate is the only academic medical center in Brooklyn, where we are at the epicenter of an increasing diabetes epidemic. The population here is extremely diverse, and around the medical center, rates of diabetes are as high as 15-20 percent. Working with the CDC and New York state, we are actively involved with community education to prevent and control diabetes complications.

My colleagues and I described a novel type of diabetes among African-Americans with a type 1 diabetes look-alike, in which they might need insulin treatment for life. In fact, they had type 2 diabetes and did not need long-term insulin. We called this Flatbush diabetes, after our neighborhood. Since then it has been recognized as a worldwide phenomenon.

We also pioneered the concept of early, intensive control of blood sugar to induce long-term remissions of diabetes. This approach promotes the preservation of the pancreas' own beta cells. Such a period of normal blood sugars could lead to decreased complications of diabetes.

People with diabetes live shorter lives by six to eight years. To prevent this and other complications, I am involved with the ACCORD trial. This is a large, multi-center, NIH-sponsored clinical trial for preventing death and complications of diabetes through the control of blood sugar, blood pressure, and lipids.