SBH Caring
FOR YOUR
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6 | SBH Caring
FOR YOUR
Health
The Bronx has the highest rate of diabetes in
the city, and one of the highest in the entire
country. In this section of the borough, about
15 percent of all adults have the disease,
according to the New York City Health
Department. What’s worse is that many people
with diabetes don’t even know they have it.
Uncontrolled diabetes can cause blindness, end-stage
kidney disease – which may require dialysis – and lower
limb amputation. It can also cause premature death. Type 2
diabetes is the most common form of the disease.
It develops in adulthood.
According to Harris Leitstein, a nurse practitioner and
certified diabetes educator at SBH Health System’s
Diabetes Center, there are a number of factors that
contribute to the diabetes epidemic in the Bronx.
First is genetics. “This disease greatly affects Hispanics
and, to a lesser extent, blacks, who pass it down from
generation to generation.” Being overweight is another
major risk factor, which Leitstein attributes to the lack of
fresh food in the Bronx.
“Processed food tends to have more carbohydrates
and fat than fresh meat, fish, poultry and produce,”
he says. “It’s cheaper and much more available in the
Bronx, which has been referred to as a ‘food desert.’”
The good news is the SBH Diabetes Center can help.
If you are an adult with diabetes, the Center offers many
valuable services – most importantly, patient education.
“We’ve found – and research has shown – that the more
we can educate people, the better they are staying with
their program,” says Leitstein. “Personally, I’ve found time
and again that if you teach patients why they should do
something, they are more likely to do it than if you say,
‘OK, take this pill and I’ll see you in three months.’”
If you are facing roadblocks to getting care and sticking
with your treatment, the Center can help with that, too.
Our staff, which speaks both English and Spanish,
will take the time to discuss the disease with you, work
to solve insurance problems, and even provide free
medication when there is a gap in coverage. The care
team also includes a pharmacist, who is a certified
diabetes educator and a nutritionist. The Center is
supervised by an endocrinologist, Dr. Gilbert Brovar.
Common Diabetes Terms
Here are some important terms to know
when it comes to diabetes.
A1C
A test that measures your average blood glucose level. An
A1C of 6.5 percent or higher in two separate tests means
you have diabetes. A result between 5.7 and 6.4 percent
is considered prediabetes, which indicates a high risk of
developing the disease.
Beta cell
A cell located in the pancreas that makes insulin.
Blood glucose
The main sugar found in your blood and the body’s main
source of energy. It is also called blood sugar.
Blood glucose level
The amount of glucose in a given amount of blood.
Blood glucose meter
A small, portable machine that checks a diabetic’s blood
glucose levels.
Combination therapy
The use of different medicines together (usually insulin and
an oral medication) to manage the blood glucose level of
those with Type 2 diabetes.
Diabetic retinopathy
Damage to the small vessels in the retina due to diabetes
that can cause loss of vision.
Gestational diabetes
Diabetes that develops during pregnancy and usually
disappears upon delivery, but increases the mother’s future
risk for diabetes.
Hyperglycemia
Extremely high blood glucose. Fasting hyperglycemia is
blood glucose above a desirable level after you have fasted
for at least eight hours.
Hypoglycemia
A condition that occurs when your blood glucose is lower
than normal. Signs include hunger, nervousness, shakiness,
perspiration, dizziness or light-headedness, sleepiness
and confusion.
Insulin
A hormone that helps the body use glucose for energy.
Insulin pump
An insulin-delivering device about the size of a deck of cards
that can be worn on your belt or kept in your pocket.
Peripheral neuropathy
Nerve damage that affects the feet, legs or hands due
to diabetes.
Type 1 diabetes
Most often developing in young people; high blood glucose
levels are caused by a total lack of insulin.
Type 2 diabetes
Developing most often in middle-aged and older adults, high
blood glucose levels are caused by either a lack of insulin or
the body’s inability to use insulin efficiently.
Diabetes in the Bronx:
ON THE FRONT LINES OF AN EPIDEMIC
Treatment of Type 2 diabetes, says Leitstein, has benefitted
from the development of new medications that can be taken
by mouth and by injection. It’s no longer simply a case of
giving patients insulin, he says, but looking at other factors
that can affect blood sugar, like the liver as
well as the pancreas. Also, medications are more effective
when patients eat healthier and exercise more.
Changing your eating habits is also a major component
in managing your diabetes. Diets that are heavy in
carbohydrates (including rice, a popular ingredient in many
cultures) add pounds and increase blood sugar. “We don’t
want to eliminate rice, but we tell patients that it’s important
to eat it in moderation,” Leitstein says. “If they follow this,
their blood sugar goes down and they can do pretty well.”
During initial meetings with newly-diagnosed patients,
staff at the Center also screen for obstructive sleep
apnea and depression through the SBH Sleep Center
and SBH Behavioral Health. People with Type 2 diabetes
are more likely to develop sleep apnea than the general
public. Depression will also have a major effect on you.
“Depression affects everything,” Leitstein explained,
“If you’re depressed, you’re less likely to be able to
help yourself. When you can overcome or manage your
depression, you do better with diabetes.”
The staff also works to change attitudes. According
to Leitstein, many patients have a gloomy view of
their conditions.
“I often hear patients say, ‘My mother had it and she had
a leg amputated, or my brother died at 42 and so this is
my fate,’” he says. “Our job is to break that kind of thinking.
And if you can do that, patients can do well.”
The SBH Diabetes Center is located at the Center for
Comprehensive Care on the 4th floor of St. Barnabas Hospital.
You can make an appointment by calling 718-960-3730.
“
This disease greatly affects Hispanics
and, to a lesser extent, blacks, who pass
it down from generation to generation.
”
