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As reported by Reuters, the cost of treating diabetes may increase by as much as 68% through 2009…
In their Drug Trend Report, Medco Health Solutions, Inc, reports the number of diabetes prescriptions trails only cholesterol prescriptions. Diabetes scripts are predicted to take first place in year over year growth.
Spending on diabetes drugs is rising 10-20% annually with a number of new drugs soon to come onto market. And of course diabetes is rising in epidemic numbers…
More diabetics + more drugs = many more bucks for big pharma.
Oh yea, I did promise good news…
Medco Chief Medical Officer Robert Epstein:
“While prevention of type 2 diabetes needs to be a national priority, drug treatments can help prevent the onset of complications from diabetes that lead to hospitalizations, more complex treatment and dramatically higher costs.”
You see, it could cost even more.
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read time: 417 words, about two minutes
In an apple versus pear comparison, the pear is by far the healthier option.
I’m not referring to fruit here, but rather to physical shape. Apple shape being wide through the belly. Pear shaped being wider through the hips.
What researchers have found is that not all fat is created equal. They’ve shown that ab fat has a high association with poor insulin response and inflammation.
In a study done back in 2004 at Washington University School of Medicine in St. Louis, liposuction was used to remove about 20% of people’s total body fat mass. While that gave them different wardrobe options, there weren’t the expected metabolic benefits found with weight loss by diet and exercise.
Liposuction removes subcutaneous fat… fat right under the skin.
It does not remove visceral fat… fat that surrounds the organs. Those fat cells are more difficult (and dangerous) to get to.
Diet and exercise doesn’t remove fat cells – it shrinks them, with no apparent preference for subcutaneous versus visceral.
Back to the results… in a second phase, researchers studied the blood to determine if visceral fat was the problem, or a symptom. In this study, they took blood from obese patients going through gastric bypass surgery.
They showed visceral fat was secreting interleukin-6 (IL-6) - an inflammatory molecule – into portal vein blood. Portal vein blood had levels of IL-6 50% greater than blood at the periphery.
Increased levels of IL-6 correlated with C-reactive protein (CRP) which is an inflammatory substance.
Chronic inflammation is associated with insulin resistance, hypertension, Type 2 diabetes, atherosclerosis and other diseases.
So let’s look at a few things…
Sucking out the fat doesn’t remove the health consequences.
Manufacturers of statin drugs keep telling you to lower your cholesterol – by taking their drugs for the rest of your life. And yet, folks with low and “normal” cholesterol have heart attacks and congestive heart failure. Why – inflammation.
Assistant professor of medicine Luigi Fontana, M.D., Ph.D.:
“Many years ago, atherosclerosis was thought to be related to lipids and to the excessive deposit of cholesterol in the arteries. Nowadays, it’s clear that atherosclerosis is an inflammatory disease. There also is evidence that inflammation plays a role in cancer, and there is even evidence that it plays a role in aging. Someday we may learn that visceral fat is involved in those things, too.”
A lifetime of poor nutrition and lack of exercise isn’t going to be sucked away in a simple outpatient procedure or blasted away with a daily pharmaceutical regimen.
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read time: 159 words, about a minute
Dr. Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University in New Haven, Connecticut, analyzed and reviewed 88 studies which explored the relationship between soda and poor nutrition, obesity and diabetes.
No surprise – at least to me – there is one.
Results of one particular study published in the American Journal of Public Health followed 91,000 women for 8 years.
The findings: women who drank one or more sodas per day (national average consumption is two, 12-ounces), were twice as likely to develop diabetes over the course of the study as compared to women who drank less than one soda per month.
So basically, if you’re an average or more soda drinker, you’re twice as likely to develop diabetes.
And as noted in the previous post… that means you’re also 65% more likely to develop Alzheimer.
Shouldn’t there be a Surgeon General’s warning on soda?!?
What has a greater health impact…
Cigarettes or soda?
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New research shows that Diabetes also slows down your brain. Brain cells deteriorate, plaque forms.
In fact, folks with diabetes have a 65% greater chance of developing Alzheimers.
In the last 20 years, Diabetes has doubled. It now affects over 20 million people.
Need more reasons to avoid high sugar and highly processed food products?
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read time: 364 words, under 2 minutes
The CDC just issued a report - The State of Aging and Health in America 2007 – that looks at a number of data points on a State by State basis.
Let’s look at a couple of current data points (this applies to the U.S. population):
- 80% of folks over 65 have one or more chronic diseases that can lead to disability and/or premature death.
- Health care costs are 3 to 5 times greater for the 65+ group as compared to younger adults.
In 2030:
- The 65+ population by the year 2030 - that’s just 23 years from now - will nearly double to 71 million / 20% of the total population.
- Health care costs will increase by another 25%.
The report notes that 35% of deaths in 2000 are attributed to 3 behaviors:
-> smoking
-> poor diet
-> lack of physical activity
Why? These behaviors lead to the top chronic diseases – heart disease, cancer, stroke, diabetes.
What’s missing in this picture is the impact of excessive weight and obesity. Not because there isn’t one, but because it isn’t showing up in older data. The dramatic increase in obesity has been in the last 10 years. That trend is still in tact.
Chronic conditions take time.
However in the present, snippets like number of weight surgeries (lap band, bariatric) have tripled in teens portend future impact.
Here’s the thing. These are chronic conditions – meaning with you everyday – that develop over time. Diet and lifestyle choices you’re making right now are forming your reality in 2030.
As a culture we have a difficult time “saving for tomorrow”. That’s true in a financial sense as well as a health sense. Unfortunately chronic conditions generally can’t be “fixed” quickly or easily.
What choices are you making today – for yourself and for your children? If we raise our children with good diet and lifestyle habits, they’ll never need to be “re-trained”. And if we start taking care of ourselves immediately, we’ll enjoy better health now and in the year 2030 and beyond.
The CDC report concludes:
If people adopt healthier lifestyles, they will not develop the expensive, chronic diseases that raise health costs sharply, such as diabetes, cancer and heart disease.
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read time: 634 words, about 5 minutes
On CNN House Call this past weekend, Dr. Sanjay Gupta. interviewed former Secretary of Health and Human Services Tommy Thompson.
I’m sure during his tenor he saw a lot of data and spoke with a vast number of authoritative folks.
Here’s some data:
~ 92% of all healthcare dollars are spent after people get sick. (7% spent for not sick services).
~ 75% of healthcare dollars are spent on chronic illness.
It’s funny that we even call it healthcare. Isn’t that a misnomer? Shouldn’t it be called sick care?
And if you went to your Doctor and wanted information on living a healthy life, what would you get?
In 2003 the Princeton Review surveyed every US accredited medical school (122) and accredited osteopathic school (19) about nutrition education in their curriculum.
40% of the schools had a nutrition requirement. The average amount of nutritional training at the schools that required any was 2.5 credit units – about 38 hours.
In their book “The Real Age Diet”, Drs. Michael F. Roizen and John La Puma revealed, “The two of us combined received fewer than eight hours of education on nutrition in more than six thousand lecture hours in medical schools”
Dr. Michael A. Klaper, Director of the Institute of Nutritional Education and Research:
“What’s really tragic about this is that we were so busy learning how to fix broken arms, deliver babies and do all of those ‘doctor’ things in medical school that we considered nutrition to be boring. But after we get into practice, we spend most of the day treating people with diseases that have huge nutritional components that have long been essentially ignored.”
I don’t want to bash Doctors. I’m questioning our focus. Clearly, nutrition isn’t a focus in medical school.
According to former Secretary Thompson, the top three health issues are:
Tobacco: 442,000 Americans deaths/year.
Diabetes: $1 out of $14 of the $2 trillion healthcare dollars goes to treat diabetes.
Last year 18 million folks were diagnosed with Type 2 diabetes. This year that bumps up to 21 million – a 17% increase. On the path to Type 2 diabetes are 41 million pre-diabetic Americans.
Following the trend out 5 years projects 62 million Type 2 diabetic Americans.
Obesity. Obesity is a chronic condition, but it’s also a bit unique in that it is increasing at rates previously experienced only with infectious diseases. More that 10% of kids between 2 and 5 are already overweight or obese. 2/3rds of adults are overweight and nearly half of those (about 30% of the total population) are obese. 16% of children – obese.
As far as the ranking, I’ll have to disagree with Thompson.
I’d put obesity first, diabetes 2nd and tobacco 3rd. Here’s why:
We’ve dumped a lot of money and education into smoking prevention and quitting.
When you look at where education and prevention effort has been, it’s tobacco, alcohol and drugs. Additionally, over the past few years smoking has been, and continues to get banned from more and more public places.
So the awareness is there, it’s heavily taxed, and it’s harder and harder to smoke anywhere. People are more educated and their behaviour is penalized.
Looking at obesity and diabetes… we’re just starting to publicly look at these very frightening numbers. We need A LOT more education and awareness. We need much clearer blueprints on healthy eating and lifestyle. And we need much better access to quality, nutritious food.
Personally, I think you’ll get a better return with eating and lifestyle education and obesity prevention, then you will with more tobacco prevention.
And since Type 2 diabetes is mostly the result of diet and exercise, you can turn the current trend around by turning the obesity trend around… two for the price of one.
You can grab the transcript of the House Call show here: CNN House Call transcripts.
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