NEW YORK - Hoping to save hundreds of lives, New York adopted a health code
regulation
Wednesday that will make it the first American city to keep track of people with
diabetes in
much the same way it does with patients infected with HIV or tuberculosis.

The city will occasionally use its database to prod diabetics to take better
care of
themselves.

The policy breaks new ground because it involves the collection of information
about people who
have a disease that is neither contagious nor caused by an environmental toxin.
It has also
raised privacy concerns in some quarters.

New York's health commissioner, Dr. Thomas R. Frieden, said the program's
potential to save
thousands of lives outweighs what it gives up in medical privacy.

"We will ensure that the utmost care will be taken to keep people's privacy and
information
protected," he said.

Under a revised city code passed by the Board of Health, most medical
laboratories in New York
will be required to electronically forward the results of thousands of
blood-sugar tests to the
city Health Department, which will then analyze the data to identify people
having trouble
controlling their diabetes.

Some patients might then get letters or phone calls from their doctors, prodding
them to take
medication, come in more frequently for checkups, or change their diet.

Diabetes is the fourth-leading cause of death in the city, but people who
aggressively monitor
their condition are less likely to develop fatal or debilitating symptoms,
including blindness,
kidney failure and heart problems.

When it was first proposed last summer, the program was greeted with a mixture
of excitement
and trepidation.

A spokesman for the American Diabetes Association declined to comment on the
surveillance
program, saying the group needed time to review its specifics. In general, the
ADA supports
diabetes registries but says patients should be asked for their consent before
their health
information is seen by anyone other than their doctors.

Frieden said people skittish about their privacy will be allowed to opt out of
the program.
Details on how that would work, however, are still being developed.

New York's first use of such a health registry came in the late 19th century as
part of a
battle against an epidemic of tuberculosis. Since then, the list of illnesses
reported to city
officials has steadily expanded, but still consists mostly of contagious
illnesses or ones with
an environmental cause, like food poisoning.

Frieden said diabetes' status as a leading killer made it just as important to
watch as any
contagious disease.

Diabetes killed 1,891 New Yorkers in 2003, the last year for which figures were
available.

DREW
T2 since '91