by Paolo von Schirach –
WASHINGTON – I recently read a very well researched article on the growing cost of treating millions of diabetics in the United States. It appeared in a major national newspaper and it was written by a well-known public policy scholar. The writer provided up to date data on the alarmingly large dimension of this disease and how much it costs to the affected individuals, insures and the US Government. The scholar in the end provided his thoughtful policy recommendations.
It is a preventable disease
All in all, a good, balanced piece. Except for one thing. In his article, the author started from the implicit premise that type two diabetes “just happened” in America. It seems that for some (unexplored and unexplained) reasons it came about and has now reached incredibly large proportions. Millions of Americans, including young people, are now its victims. Now, according to the author, our problem as a society is how to pay for the monstrous and increasing costs of caring for millions of patients. Not a word –repeat, not a word– about the genesis of this explosion, even though it is well known.
Well, this approach to this US health care crisis is totally wrong. I repeat: totally wrong; because it fails to mention how type two diabetes came about and –most fundamentally—that type two diabetes is a preventable disease. Yes, preventable, and this means avoidable. Which is to say that the analysis included in the article is fatally flawed, because it starts from the false premise that this health care crisis just “happened”. The implicit assumption is that, as a nation, we have to accept this reality, and now going forward our job as a society is to figure out how to pay for its immense cost.
The author says: “We have an explosion of a disease that cost billions. Let’s discuss the best way to apportion the cost”. Wrong! A good analyst would ask a very different question:
“Why is it that we are doing nothing to prevent a preventable disease that has now gained monstrous dimensions, this way causing misery to millions of Americans, while burdening the health care systems with billions of dollars in therapies that could be completely avoided”?
Let me clarify. The ballooning of diabetes in recent years is mostly about type two diabetes. (Type one diabetes is a different story. It has some genetic roots that make certain individuals more susceptible. But the explosion of diabetes in recent years in America is overwhelmingly about type two which has no genetic roots).
Unlike other health care scourges, this is not a conventional epidemic. Type two diabetes is not genetic, and it is not a communicable malady, carried by a virus or bacteria. You do not get type two diabetes because you have been in the proximity of someone who has it.
A consequence of bad life style
Type two diabetes is a pretty horrible chronic disease that manifests itself as a consequence of years of bad eating habits (too much sugar, too many carbohydrates), and bad lifestyle (no exercise).
Which is to say that if most Americans would embrace and sustain a healthy life style, (eat mostly lean proteins including fish, vegetables, fruits, salads, go to the gym 3 or 4 times a week, and keep a normal weight), the chances of developing type two diabetes are practically zero.
Just like that? Yes, just like that.
Again, type two diabetes is not genetic, and it is not an epidemic. This is a bad life style disease. The fact that millions of Americans get it and collectively end up spending billions of dollars to treat it does not change any of these facts. It simply means that millions of Americans, regrettably, embraced bad personal habits that caused them to develop type two diabetes while piling up skyrocketing medical costs.
That said, amazingly, almost no one (including the author mentioned above) points that this is a preventable disease while discussing the consequences of the massive increase of type two diabetes cases. And yet, these are well-known facts.
You realize what this means. If people had a chance to be properly educated about the critical importance of a good diet and exercise and consequently changed their eating and exercise habits in order to stay healthy, type two diabetes would practically disappear –with enormous health care cost savings, and immense quality of life gains for millions of diseased people.
It is preventable!
At least some tell you the real story. The Harvard School of Public Health website explains that:
“The good news is that prediabetes and type two diabetes are largely preventable. About 9 in 10 cases in the U.S. can be avoided by making lifestyle changes. These same changes can also lower the chances of developing heart disease and some cancers. The key to prevention can be boiled down to five words: Stay lean and stay active.”
Got that? At least 9 out of 10 cases are preventable. The secret? Five words: “Stay lean and stay active”. Yes, that’s all there is to it.
And it is also reversible!
And this is not the whole story. Type two diabetes is actually reversible. Not always. But in many, if not most cases you can get rid of it.
Here is what US News recently reported:
“It’s not impossible at all to reverse diabetes,” says Dr. Peter Arvan, chief of the division of metabolism, endocrinology and diabetes at the University of Michigan. Certainly, though, experts are quick to point out that often what it takes to do so, such as wholesale changes to completely alter the way one eats and shifting one’s schedule to prioritize exercise, can be challenging to say the least.”
“Sometimes diabetes remission is achieved following bariatric weight loss surgery. But for the majority, it’s intensive changes to a diet, such as consuming lots of fruits and veggies and complex carbs and little sugar, and accompanying weight loss that seems to be a core driver in lowering blood-sugar.”
“Of course there are a lot of patients who have difficulty complying with those lifestyle changes,” Arvan says. “It is not the case that reversing their diabetes is the one and only thing that’s on that person’s mind all day long.” So the same struggles people may have in properly controlling diabetes can dog even loftier goals of achieving remission.”
It is imperative to change lifestyle
So, according to this eminent physician, the main obstacle to getting rid of this nasty disease is the willingness on the part of the patients to completely change their lifestyle. Difficult, perhaps. But not an impossible task, if the affected individuals are properly guided and counseled by nutritionists and doctors.
So, given the fact that we can both prevent and reverse this nasty disease, why is it that we do not have well-crafted public education campaigns aimed at explaining the critical value of good nutrition and regular exercise? Why are we not teaching “wellness” in America?
As a nation we certainly have the skills and the resources to do this. We did launch massive education campaigns when it came to raising awareness about the horrible health consequences of smoking.
No interest in promoting wellness
If we are into conspiracy theories, we could argue that not creating prevention programs focusing on wellness education aimed at the general public is in fact deliberate. Indeed, it is very much in the financial interest of the health care industry, (pharmaceutical companies, hospitals, and doctors), not to teach anybody about how to adopt a healthy nutrition program, while engaging in moderate physical activities.
How so? Well, if you think about it, this type two diabetes explosion is really a big money bonanza for the health care sector. If you are a pharmaceutical company that makes and sells insulin, (the medication prescribed to all diabetics), or if you are a physician who regularly monitors affected patients, type two diabetes is a veritable gold mine. For medical practitioners who are paid based on the number of treatments, there is nothing better than millions of chronically ill patients who need life time treatment. Which is to say that the entire US health care industry benefits financially from the bad habits of millions of sick Americans.
Save money, improve lives
Needless to say, drastically curtailing the incidence of type two diabetes cases through targeted wellness education campaigns would save America billions of dollars every year, while improving the quality of life for millions of chronically ill patients. But you do not see the headlines explaining any of this. in the absence of wellness programs, diabetics keep doing what they are told. They have to keep monitoring their blood sugar levels (yes, sell more of those monitoring devices!) and take more insulin.