Flatbush Diabetes

“Flatbush diabetes” was identified in 1994 by Dr. Mary Ann Banerji and others at the Diabetes Center of SUNY Downstate Medical Center in East Flatbush, Brooklyn. (It is, perhaps, more properly “East Flatbush diabetes” and was not named after Flatbush Avenue, as one source claims.)  Flatbush diabetes was first thought to be a type 1 diabetes (requiring insulin treatment), but doctors found this diabetes to be closer to type 2 (not requiring regular insulin).
 
Flatbush diabetes was found in the middle-aged African-American community and has been rare in Caucasians.
 
   
Wikipedia: Diabetes mellitus
Diabetes mellitus (pronounced /ˌdaɪ.əˈbiːtiːz/ or /ˌdaɪ.əˈbiːtɨs/; /mɨˈlaɪtəs/ or /ˈmɛlɨtəs/)—often referred to simply as diabetes—is a condition in which the body either does not produce enough, or does not properly respond to, insulin, a hormone produced in the pancreas. Insulin enables cells to absorb glucose in order to turn it into energy. In diabetes, the body either fails to properly respond to its own insulin, does not make enough insulin, or both. This causes glucose to accumulate in the blood, often leading to various complications.
 
Many types of diabetes are recognized: The principal three are:

. Type 1: Results from the body’s failure to produce insulin. It is estimated that 5–10% of Americans who are diagnosed with diabetes have type 1 diabetes. Presently most persons with type 1 diabetes take insulin injections.
. Type 2: Results from Insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes. Many people destined to develop type 2 diabetes spend many years in a state of Pre-diabetes: Termed “America’s largest healthcare epidemic,”, pre-diabetes indicates a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. As of 2009 there are 57 million Americans who have pre-diabetes.
 
Wikipedia: Flatbush, Brooklyn
Flatbush is a community of the Borough of Brooklyn, a part of New York City, consisting of several neighborhoods.
 
The name Flatbush is an Anglicization of the Dutch language Vlacke bos (“flat woodland” or “wooded plain”).
 
The Flatbush Post Office is assigned postal zone (ZIP Code) 11226, but the area understood as included in Flatbush extends into other postal zones.
 
The Flatbush community has been receiving an influx of immigrants from the Caribbean, mostly from Haiti, Trinidad, Jamaica, Grenada, Guyana, Barbados, and Belize since the 1980s, as well as immigrants from India and African countries like Ghana, Zimbabwe, Nigeria, and Kenya. Haitians are the largest ethnic group in Flatbush. Prior to the arrival of these groups, the Flatbush community had already been diverse, with many Italians, African-Americans and Jews. Flatbush is patrolled by the NYPD’s 70th Precinct.
   
Wikipedia: East Flatbush, Brooklyn
East Flatbush is a neighborhood in the New York City borough of Brooklyn. The area is part of Brooklyn Community Board 17. Though the borders of East Flatbush are highly subjective, its northern border is roughly at Empire Boulevard and East New York Avenue east of East 91st Street, its southern border is in the vicinity of the LIRR Bay Ridge Branch, its eastern border is roughly at East 98th Street and its western border is roughly at New York Avenue.
 
The area was populated post World War II predominantly by immigrant Jews and Italians, then in the 1960s by African Americans, but most recently has seen many West Indian immigrants such as Haitians, Jamaicans, Trinidadians, Grenadians, Bajans, and Guyanese groups coming to the area. Within its confines is the Holy Cross Cemetery, which is located at 3620 Tilden Avenue. While there are some affluent residents present, East Flatbush is mostly populated by working-class Brooklynites. Similar to other eastern Brooklyn neighborhoods, blacks predominate East Flatbush. The area has a population of 84,498 and is 91.4% African-American. East Flatbush is the home of the former General George W. Wingate High School and Gov. Samuel J. Tilden High School. It is also home to three major hospitals, Kings County Hospital, SUNY Downstate Medical Center, and Kingsbrook Jewish Medical Center.
   
OrganizedWisdowm - Health
Research Notes on Flatbush Diabetes
Flatbush diabetes is a variation of diabetes that was first identified by physicians in the East Flatbush section of Brooklyn in 1994. Flatbush diabetes has been classified as subtypes of type 1 and type 2 diabetes. Diabetic ketoacidosis is the first symptom of Flatbush diabetes, which was often thought only to occur in type 1 diabetes.
 
Fast Facts:
. Flatbush diabetes usually occurs in the African-American community.
. Flatbush diabetes can occur in Hispanics, but is rare in Caucasians.
. People with Flatbush diabetes are often overweight, and have a family history of type 2 diabetes.
 
MyDiabetesCentral.com
Flatbush diabetes
(...)
But there’s another form of diabetes that seems to becoming more and more common, especially in Africa, and that’s Flatbush diabetes, named after the New York area where it was described some years ago.
 
It’s also been called a lot of other things, including atypical diabetes, type 1B diabetes, idiopathic [meaning the cause is unknown) type 1 diabetes, and ketosis-prone type 2 diabetes.
 
I’ll use the term Flatbush diabetes because I find it easier to rememember colorful nicknames, and also because it doesn’t require one to decide if this form of diabetes is really type 1 or type 2. In fact, it seems to be somewhat in between.
 
Flatbush diabetes is found primarily in nonwhite populations, especially those of sub-Saharan African descent, although Asians, Hispanics, and even Caucasians can be diagnosed with it.
   
New York (NY) Daily News
FLATBUSH DIABETES
By Amanda Gardner
Monday, November 22th 1999, 2:11AM
Doctors used to divide diabetes cases into two neat camps: Types 1 and 2. But the disease is not quite that simple. Flatbush diabetes, one of several variations of the disease, was identified in 1994 at SUNY Downstate Medical Center in the East Flatbush section of Brooklyn.
 
The first symptom of Flatbush diabetes is usually diabetic ketoacidosis (DKA), a potentially fatal buildup in the blood of chemicals known as ketones, which results when the body stops producing insulin and burns an excessive amount of stored fats. (Sometimes the first symptom of Flatbush diabetes is severe hyperglycemia, or high blood sugar.)
 
It was once thought that DKA only occurred in Type 1 patients. When middle-aged African-Americans in Flatbush were diagnosed with it, doctors assumed they were Type 1 also, even though they didn’t fit the age or weight criteria.
   
The Journal of Clinical Endocrinology & Metabolism
Vol. 88, No. 11 5087-5089
Copyright © 2003 by The Endocrine Society
Editorial
Ketosis-Prone Diabetes—A New Subgroup of Patients with Atypical Type 1 and Type 2 Diabetes?
Abbas E. Kitabchi
(...)
These two groups have been described globally by various names, including “Flatbush diabetes,” “obese DKA,” “type 2 DM with DKA,” “newly onset with DKA,” “idiopathetic type 1 DM,” “atypical DM,” “type 3 KPD,” as well as “KPD B+.”
     
Google Books
Handbook of Diabetes
3rd edition
By Gareth Williams and John C Pickup
Malden, MA: Blackwell Publishing
2004
Pg. 118:
The condition is well described in obese African-American adults and children, and has been termed ‘Flatbush’ diabetes, after the avenue in New York where the first patients lived. The immunogenetic markers of classic type 1 diabetes are absent.
 
Google Books
Oxford Handbook of Clinical and Laboratory Investigation
By Drew Provan
New York, NY: Oxford University Press
2005
Pg. 178:
‘Flatbush’ diabetes. Some young Afro-Caribbean patients present in diabetic ketoacidosis but subsequently have a disease course that is more like type 2 diabetes.
   
ABC News
SUNY Downstate Medical Center, N.Y.
Mary Ann Banerji, M.D., Director, Diabetes Center; Professor of Medicine, SUNY Downstate
November 13, 2007
SUNY 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.
 
SUNY Downstate Medical Center
Downstate Research
Profiles in Innovation
2007
Pg. 52:
Dr. (Mary Ann—ed.) Banerji and her team have been on the forefront of other medical breakthroughs. In 1994, they identified a previously unreported form of diabetes in people of African descent. Termed “Flatbush diabetes” after (Pg. 53—ed.) SUNY Downstate’s Brooklyn neighborhood, the illness has an unusal presentation. It primarily affects adults and presents with ketoacidosis, a state of insulin deficiency characterized by high levels of acids and sugar in the blood.