After more than five weeks in a hospital, Mayor Thomas M. Menino has been diagnosed with type 2 diabetes, a chronic disease that doctors detected after an unusual infection developed near his spine.
Dr. Charles Morris made the diagnosis public Monday at a news conference as he announced that the mayor had been transferred from an acute-care facility to a rehabilitation hospital.
Diabetes and the back infection add to the growing list of Menino's ailments. Menino, 69, cut short a vacation in Italy and sought medical care for a cough and extreme fatigue. Doctors initially diagnosed him with an upper respiratory infection and a blood clot in his lungs. In the hospital he suffered the fracture in his spine. The mayor had been in Brigham and Women's Hospital since Oct. 26.
For now, doctors remain focused on Menino's lower back, where he suffered a compression fracture in one of the vertebrae before the infection. Out of public view Monday afternoon, Menino was wheeled out of the Brigham on a gurney and was taken by ambulance to Spaulding Rehabilitation Hospital near North Station.
"He needs now to focus on getting his strength back and getting back to where he was before this all started," Morris said. "He is walking, but there is room to get stronger. That is why we are recommending a stay in rehab."
Menino had begun to recover from the fracture in his back, Morris said, when he developed the infection in the same area. Diabetes can make people more susceptible to infection, Morris said, and likely contributed.
Despite the growing list of ailments and the diagnosis of a chronic condition, Morris remained upbeat about Menino's prognosis.
"I think his overall health at this point is very good," Morris said, adding, "It is a run of bad luck. It is nothing that concerns me. He will rebound from this."
Menino has not set foot in City Hall since he left for Italy more than six weeks ago. As outlined in the city charter, Menino relinquished some of his power while abroad, transferring duties to City Council President Stephen J. Murphy. Since returning to the United States, Menino has again taken command of those tasks and runs his administration from his hospital room, according to his aides.
"He is absolutely able to continue his business with the city," said Menino's spokeswomen, Dot Joyce. "He is very focused on his care right now and the business of the city."
City Councilor Charles C. Yancey suggested Monday that Menino consider allowing Murphy to again take on some of his responsibilities, specifically referring to weekly financial documents that the chief executive must review and sign.
"The mayor should consult with his doctors and determine if at least some duties should be transferred to the council president on an interim basis," Yancey said. "The public would understand if he needed a break."
In an interview Monday, Murphy said the mayor remained in charge and that there had been no discussion of any transfer of power.
"There's been no conversation like that at all," Murphy said. "He's been in command since he's been back on United States soil. I know he has been in pain, but that hasn't stopped him and his team from doing what do they need to do."
The larger question will be whether Menino runs next year for a sixth term. While hospitalized, he has continued to raise money, with his campaign depositing almost $5,000 on Monday alone. His doctors said that the latest health woes should not prevent him from running again.
"I can't speak to his political future," Morris said Monday. "But I don't see his medical issues being an obstacle there at all."
Type 2 diabetes is a chronic condition in which high blood sugar can cause problems with the heart, circulatory system, and nerves. If left untreated, complications can include blindness, kidney failure, and the amputation of limbs.
"About one-third of all affected people will have some type of complication," said Dr. Adrian Vella of the Mayo Clinic in Rochester, Minn. "Appropriate management mitigates and minimizes this risk. But it doesn't make it go away completely."
Treatment can include medication, insulin injections, increased exercise, and a change in diet. Almost 26 million Americans have type 2 diabetes, which is the most common form of the disease. It afflicts 25 percent of people over age 65, according to Chris Boynton, executive director American Diabetes Association of New England.
Leading risk factors for type 2 diabetes include weight and age, but some people can also be genetically predisposed to develope the disease, Boynton said. Many patients will need to make significant lifestyle changes, which include a diet high in fruits and vegetables and low in sweets and desserts.
"There is no diabetes diet; it's just a healthy diet," he said. "If you are someone who is Italian, who loves Italian food, you can make that work if you manage it."
Boynton said that people with diabetes can live perfectly productive, normal lives.
"Somebody living with diabetes can do the same job as anyone else," he said.