According to a RAND Corporation study, fewer and fewer diabetics are going undiagnosed these days. Specifically, the gap has closed dramatically over the last twenty-five years. So much so that Hispanics and African Americans are now no more likely than whites to be undiagnosed. Good news, to be sure.

And the news is especially good for men. James P. Smith, who authored the study, says that twenty-five years ago about fifty percent of men with diabetes did not even know they had the disease. Jump forward to 1999-2002, however, and the number drops to about twenty percent.

Smith concludes that even though ethnic and gender disparities remain, we are certainly doing a lot better at getting people diagnosed and into treatment. Diabetes programs that target minorities can take a lot of the credit for this shift, Smith believes.

On the down side, the less-educated people among us are much more likely to go undiagnosed and, when diagnosed, are less likely to successfully incorporate lifestyle changes required to manage the disease. Also of concern, Smith says, is the fact that even though obese people are at a high risk for diabetes, they nevertheless are more likely to have undiagnosed diabetes than are slimmer people.

Worrisome news released Tuesday courtesy of the Centers for Disease Control and Prevention (CDC): diabetes cases in the US are expected to triple by 2050. That would mean 48.3 million Americans would be suffering from the disease. That's a lot, to be sure. What makes this announcement really significant, however, is the fact that the CDC found it necessary to increase its previous prediction - made in 2003 - by 9.3 million to arrive at this figure. It also predicts that, viewing the increase by ethnic group, diabetes will climb 481 percent amongst Hispanics, 208 percent for blacks and 113 percent for whites.

The man chiefly responsible for the new number is K. M. Venkat Narayan, formerly of the CDC and now at Emory University. Says Narayan in a Fox News feature, "The numbers are very worrying. There is an epidemic going on that - if left unchecked - will have a huge effect on the US population and on health care costs." On the other hand, Narayan's advice is not to panic just yet. "There are effective interventions available. If we could apply those interventions across the country, we could slow down the diabetes rate." Meaning that it's possible these dire predictions might never come to pass.

Fox News also quotes Ronald B. Goldberg of the Miami Leonard M. Miller School of Medicine. Goldberg goes even further than Narayan, predicting that the economic consequences of unchecked diabetes growth "will cripple our health care budgets." Of the lifestyle interventions required to check climbing diabetes rates, he says "We have made some progress, but unfortunately not enough."

NY1 News is running a really fascinating little piece about diabetes and diversity in the New York area. Health professionals are realizing that they face an added challenge in fighting the rising tide of diabetes: the ethnic diversity of the region is amazing. This diversity is something that physicians and other other professionals must grapple with to ensure that everyone has access to good diabetes care.

The article profiles Queens, where almost fifty percent of the people are immigrants. Dr. Isaac Sachmechi, at the Queens Hospital's Center for Excellence in Diabetes Management says, "We have southeast Asian, we have Guyanese, we have Hispanics, we have African-Americans, so we have a diversity of patients. Each ethnic group, they have their own diet, different diets, different cultures that we have to address when we see and treat these patients." For instance, diabetes patient Sradhanan Ramrattan, says his traditional Indian diet consisted of lots of carbohydrates, which he now knows meant he was unwittingly overloading on sugar.

Dr. Sachmachi also talks about the need to understand and work within the parameters of different cultures. "Different populations, they have different attitudes towards the disease itself," he says. "If they have an ethnic background they are not going to give up that ethnicity because that is not something they can change. So you have to help them adjust and adapt to the illness as well," says diabetes educator Hildegarde Payne.

CBS News is running a report on new findings published in Diabetes Care (July 2006). The title seems a little silly to me: "Diet May Help Minorities' Diabetes." Well, duh, I thought.

Anyway, the point is that minorities (defined as African Americans, Asians and Hispanics) are more likely to develop Type 2 diabetes than are white Americans. The news is that improved eating habits may benefit these minorities in terms of controlling their diabetes than would be the case for whites. Surprised? I am.

Also from the Diabetes Care research is the news that body mass index does not fully explain why minorities suffer from diabetes at a higher rate. In other words, it's not just about weight, folks.

Finally, the researchers also concluded that gaining weight puts Asians at a particularly high risk for diabetes.

Check out the CBS article for a long summary of the research. Of course, Diabetes Care contains the full story.

Hispanic patients, University of Florida researchers have found in the course of a recent study, can be adversely affected by taking the combination of drugs (diuretics and beta-blockers) that are commonly prescribed to control blood pressure. Instead, Hispanics do better on other meds. This, in itself, is an important find. However, the UF scientists also made another announcement: they found that an unintended benefit for Hispanics of switching to other prescription drugs actually cut their risk of developing diabetes quite dramatically. (The drugs that were found to have this effect are trandolapril and verapamil.) This was all the more significant given that people with high blood pressure are widely recognized as having a particularly high risk of developing diabetes. The results have been published in the American Heart Journal (May 2006). Visit the UF's web page on the study to read more about this amazing study.