Study Finds High Rates of Type 1 Diabetes Near Food Swamps

Link to fast food availability suggests environment may influence type 1 diabetes rates

Hot spots of type 1 diabetes in New York City are found in food swamps, areas with a higher proportion of fast food restaurants, for children and adults with type 1 diabetes, according to a new study published in the Journal of the Endocrine Society.

“Traditionally, we’ve associated type 1 diabetes with genetics and type 2 diabetes with obesity,” says one of the study’s authors, David C. Lee, MD, MS, of New York University School of Medicine in New York. “Our research suggests that an adverse food environment has an important influence in type 1 diabetes, and a more thorough investigation of genetics, health behaviors and cultural influences should be considered for type 2 diabetes.”

In the retrospective cohort study, researchers from New York University School of Medicine used emergency claims data to locate New York City residents who visited a New York State emergency department at least once between 2009 and 2013 and had a history of type 1 or type 2 diabetes. Geospatial analysis was used to estimate diabetes prevalence among adults and children by census tract.

The researchers leveraged data from the city restaurant inspections and state retail food store inspections to determine which census tracts had a higher proportion of fast food restaurants and small convenience stores, which tend to offer fewer healthy food options than large grocery stores.

The researchers found higher rates of all forms of diabetes in food swamps except for children with type 2 diabetes. Those cases of pediatric type 2 diabetes were concentrated in neighborhoods with a higher proportion of black residents, suggesting there could be a genetic component at work.

“Future studies should seek to further validate these methods of estimating type 1 and type 2 diabetes prevalence among adults and children using alternative data sources,” Lee says. “Factors like cultural dietary patterns and ingrained patterns of belief around how one develops diabetes should be explored to determine what causes certain neighborhoods to face a much higher burden of disease.”