Fat City

There's been a burst of promising research in 2008 in the battle to defeat one of the worst health care crises of our generation: diabetes. One recent study suggested that weight-loss surgery could be an effective method of combating Type 2 diabetes in obese people. Another study found that aggressive treatments prescribed to drive down blood sugar levels in diabetics have been remarkably effective.

Nowhere are these developments more welcome than in New York.

Consider the numbers. In the last decade alone the number of people with diabetes in New York State has more than doubled. Right now, 1.5 million New Yorkers — roughly 7% of the state's population — suffer from some form of the disease. Diabetes now stands as the fifth leading cause of death among adults between 45 and 64 years of age. More disturbing is the fact that diabetes is the only chronic disease that continues to grow in prevalence, and at a faster pace than both heart disease and cancer. And while scientific research is essential to tackling the diabetes epidemic successfully, equally important — and too often forgotten — is the one solution for Type 2 diabetes that has been proven time and again to work: prevention.

Type 2 diabetes is preventable and brought about by poor nutrition, lifestyle choices, and environmental factors that can be controlled. Most experts believe Type 2 diabetes is becoming more prevalent because our lifestyles are becoming ever-more sedentary and our diets are evermore dominated by high-calorie, high-fat, and convenient food choices.

The alarming increase in obesity and diabetes in recent years is almost certainly not a coincidence. Since 1993, as diabetes rates have steadily increased, New York has seen a 37% increase in the number of obese adults. And while diabetes was previously almost nonexistent among children, childhood obesity now stands at epidemic proportions, and juvenile Type 2 diabetes has also increased. We can no longer deny the effects of junk food and fast food that are the sad staples of the American diet — especially in low-income communities. Yet, the battle to curb the obesity and diabetes epidemic cannot be fought solely at the dinner table.

True prevention requires much more than good lifestyle choices. It involves the social will to create environmental conditions that support healthy living. Our governments and employers can be more health-friendly by creating places to safely exercise — walking paths and bike paths — and by ensuring that healthy food choices such as fruits, vegetables, and low-fat foods are available in our schools and neighborhood groceries.

As a nation we have arrived at this alarming precipice because of our fast food culture and a failure to adequately emphasize physical activity in schools and work places.

If we want to make strides in beating diabetes in the near future, we must promote preventive and non-invasive measures like nutrition and exercise, which have long received scarce attention and far too little funding.

The emphasis we have placed on medical treatments has come at the expense of planning for effective preventive measures. Science and research appear to be slowly but surely doing their part. Yet the best and most cost-efficient treatment is to prevent diabetes from appearing in the first place.

It's a feat far more achievable than most people think.

Mr. Knickman is president and CEO of the New York State Health Foundation.