6 ms·

Type 2 diabetes is a solved problem, but pharmaceutical companies have yet to find a way to make money from a water fast, so no one tells people about it.

by aviv 9y ago

xupybd 9y ago
I don't know if it's a solved problem. It's very hard to get people to fast. It's even harder to get people to maintain a healthy lifestyle and body weight after going into remission.
- metamet 9y ago
  Well, the problem is solved. People just don't want to take enough ownership over their health to actually do it.
  - danharaj 9y ago
    Fasts are so hard on the body and mind that it's not at all difficult to imagine situations in which people can't afford to do it. I wouldn't be able to do my job if I did an 850kcal fast for 3 months.
    - metamet 9y ago
      Well, fasts aren't the only solution here. Changing your and adjusting your carb intake in order to offset insulin requirements can gradually get things back on track. Doing intermittent fasting isn't even that taxing once you adjust. I have been doing it for around 4 years and I work as a developer. My most productive hours are still in the morning, and I don't even eat until noon-1pm on most days. But to your point, yes, a drastic implementation of a clinical approach can be impractical. Fortunately there're a lot of ways to fix type 2 with diet which aren't as taxing. So the problem is solved. It's just that most people would rather take insulin than change their diet.
  - daxorid 9y ago
    The problem is moral hazard. If we did the right thing and cut Type 2 diabetics off from health insurance benefits (or at least dramatically increased premiums), the incentive structures would align quickly. Edit: Mildly confused about the downvotes. I am not suggesting doing this to Type 1 diabetics, or any medical condition that is not the result of lifestyle choices. Having type 2 diabetes is very much a choice.
    - logfromblammo 9y ago
      Okay, for the sake of argument, let's also refuse to pay for treatment for BASE jumpers and cave divers. Now let's refuse coverage to people who get STDs. Now people who smoke. Now people who don't fasten their seat belts. Do you see where that goes?
      - daxorid 9y ago
        Yes, I see where it goes. Either premiums would rise on the basis of lifestyle, or supplementary health insurance companies would pick up the slack. Your choice to smoke, have unprotected sex, or BASE jump would come with additional costs, which would be in addition to the cost of the cigarettes, wingsuits, etc - rather than being an externality which society pays. Note that we already do this for life insurance, and fully accept doing so. You cannot even get a short term policy without a blood test. Why should health insurance be any different?
        Tiksi 9y ago
        I've had life insurance from my last two and current employers and haven't been to a doctor at all during that time, so I guess you can?
      - aviv 9y ago
        Uhm, towards a highly efficient system? Why do I need to pay the same premium as someone who eats fast food 3 times a day and downs 4 gallons of Coke and smokes in between?
  - viraptor 9y ago
    Depends on what you see as a problem. Is it: technically what is the method of getting rid of diabetes in a controlled setting, or is it: how do we cure billions of people from general population, given the existing conditions of their lifestyle? Because the second one is the harder question. Currently it's solved in the same way world hunger is solved: just grow some plants and eat them, right?
  - xupybd 9y ago
    From the view of an individual with self control you're correct. From a societal view that doesn't help. A large percentage of the population has demonstrated a lack of self control in this area. This has lead to widespread health problems. Those problems are a burden on society. Simply saying it's your responsibility deal with it won't reduce that burden. We found a similar problem with smoking. Numbers of smokers have reduced with public education plans and limitations on marketing. Perhaps there are similar things that can be done to help reduce the number of people suffering obesity related illness. Perhaps it's something that will have a net positive impact on society as a whole? There is of course a balance interfering with individual dietary choices is a slippery slop, freedom must be preserved at all cost.
- bitwize 9y ago
  Legalize amphetamine microdosing, perhaps? :)
dagw 9y ago
As someone who has several extended family members with type 2 diabetes, I'd love to read a write up of the clinical trials supporting this.
- dorfsmay 9y ago
  Google Jason Fung, he's a former urologist who's specialised in diabetes type 2 through fasting.
DiabloD3 9y ago
It's actually worse. 1/3rd of Americans (over 100 million people) have, or are well on their way to having, Type 2 Diabetes. This is one o the largest cash cows of Big Pharma. They don't want to fix it, their bottom line depends on this never being fixed, and they will do anything in their power to make sure it is never fixed.
- dmix 9y ago
  > They don't want to fix it Bullshit. They want to solve it in a way that doesn't involve hard behavioural (exercise, dieting) or industrial changes (nutritional) for the average person. A very rational pursuit given the obvious difficulty in the other factors being slow changing. There is nothing wrong with offering medication and personal health analysis tools (blood glucose level monitors) which help manage an illness which affects a huge percentage of Americans. That doesn't mean they are actively making diabetes a widespread condition.
viraptor 9y ago
This is not really a helpful comment. It's hard to take your position seriously given the number of ads and gullible people who will tell you how everything is a big pharma conspiracy and you can cure everything from a cold to cancer with enough {prayers, vitamins, water, ...}. Any supporting study would be better.
entee 9y ago
As someone who has worked tangentially to drug discovery and who has many friends who work as scientists in pharma, I promise you this is outright false. No scientist or even evil business/lawyer person for pharma is out to suppress known cures for disease in order to make a buck. This entirely leaves aside the notion that diabetes (abbreviating as DM2 for diabetes mellitus type 2) is a solved problem. If you can maintain a low calorie diet or a water fast, then yes you will improve and may not benefit from medication. The number of people who can do that sustainably is rather small, as evidenced by the number of people who get the disease in the first place. It's not like it's a mystery that excess caloric intake and weight gain are the major risk factors for DM2. It's also not a mystery to the patient, they know they should probably cut back a little, but it turns out that diets are extremely difficult to maintain long term. See: http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-trap.html http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-... So for those people who have difficulty maintaining drastic weight loss for whatever reason, I think it's ok to have a pharmaceutical industry that tries to find alternatives. If an individual patient can do without the drugs, that's great too. In the end, lives will be saved with both approaches, they are not in conflict.

Type 2 diabetes is a solved problem, but pharmaceutical companies have yet to find a way to make money from a water fast, so no one tells people about it.

by aviv 9y ago

Type 2 diabetes is a solved problem, but pharmaceutical companies have yet to find a way to make money from a water fast, so no one tells people about it.

xupybd 9y ago

I don't know if it's a solved problem. It's very hard to get people to fast. It's even harder to get people to maintain a healthy lifestyle and body weight after going into remission.

metamet 9y ago
Well, the problem is solved. People just don't want to take enough ownership over their health to actually do it.
- danharaj 9y ago
  Fasts are so hard on the body and mind that it's not at all difficult to imagine situations in which people can't afford to do it. I wouldn't be able to do my job if I did an 850kcal fast for 3 months.
  - metamet 9y ago
    Well, fasts aren't the only solution here. Changing your and adjusting your carb intake in order to offset insulin requirements can gradually get things back on track. Doing intermittent fasting isn't even that taxing once you adjust. I have been doing it for around 4 years and I work as a developer. My most productive hours are still in the morning, and I don't even eat until noon-1pm on most days. But to your point, yes, a drastic implementation of a clinical approach can be impractical. Fortunately there're a lot of ways to fix type 2 with diet which aren't as taxing. So the problem is solved. It's just that most people would rather take insulin than change their diet.
- daxorid 9y ago
  The problem is moral hazard. If we did the right thing and cut Type 2 diabetics off from health insurance benefits (or at least dramatically increased premiums), the incentive structures would align quickly. Edit: Mildly confused about the downvotes. I am not suggesting doing this to Type 1 diabetics, or any medical condition that is not the result of lifestyle choices. Having type 2 diabetes is very much a choice.
  - logfromblammo 9y ago
    Okay, for the sake of argument, let's also refuse to pay for treatment for BASE jumpers and cave divers. Now let's refuse coverage to people who get STDs. Now people who smoke. Now people who don't fasten their seat belts. Do you see where that goes?
    - daxorid 9y ago
      Yes, I see where it goes. Either premiums would rise on the basis of lifestyle, or supplementary health insurance companies would pick up the slack. Your choice to smoke, have unprotected sex, or BASE jump would come with additional costs, which would be in addition to the cost of the cigarettes, wingsuits, etc - rather than being an externality which society pays. Note that we already do this for life insurance, and fully accept doing so. You cannot even get a short term policy without a blood test. Why should health insurance be any different?
      - Tiksi 9y ago
        I've had life insurance from my last two and current employers and haven't been to a doctor at all during that time, so I guess you can?
    - aviv 9y ago
      Uhm, towards a highly efficient system? Why do I need to pay the same premium as someone who eats fast food 3 times a day and downs 4 gallons of Coke and smokes in between?
- viraptor 9y ago
  Depends on what you see as a problem. Is it: technically what is the method of getting rid of diabetes in a controlled setting, or is it: how do we cure billions of people from general population, given the existing conditions of their lifestyle? Because the second one is the harder question. Currently it's solved in the same way world hunger is solved: just grow some plants and eat them, right?
- xupybd 9y ago
  From the view of an individual with self control you're correct. From a societal view that doesn't help. A large percentage of the population has demonstrated a lack of self control in this area. This has lead to widespread health problems. Those problems are a burden on society. Simply saying it's your responsibility deal with it won't reduce that burden. We found a similar problem with smoking. Numbers of smokers have reduced with public education plans and limitations on marketing. Perhaps there are similar things that can be done to help reduce the number of people suffering obesity related illness. Perhaps it's something that will have a net positive impact on society as a whole? There is of course a balance interfering with individual dietary choices is a slippery slop, freedom must be preserved at all cost.
bitwize 9y ago
Legalize amphetamine microdosing, perhaps? :)

dagw 9y ago

As someone who has several extended family members with type 2 diabetes, I'd love to read a write up of the clinical trials supporting this.

dorfsmay 9y ago
Google Jason Fung, he's a former urologist who's specialised in diabetes type 2 through fasting.

DiabloD3 9y ago

It's actually worse. 1/3rd of Americans (over 100 million people) have, or are well on their way to having, Type 2 Diabetes. This is one o the largest cash cows of Big Pharma. They don't want to fix it, their bottom line depends on this never being fixed, and they will do anything in their power to make sure it is never fixed.

dmix 9y ago
> They don't want to fix it Bullshit. They want to solve it in a way that doesn't involve hard behavioural (exercise, dieting) or industrial changes (nutritional) for the average person. A very rational pursuit given the obvious difficulty in the other factors being slow changing. There is nothing wrong with offering medication and personal health analysis tools (blood glucose level monitors) which help manage an illness which affects a huge percentage of Americans. That doesn't mean they are actively making diabetes a widespread condition.

viraptor 9y ago

This is not really a helpful comment. It's hard to take your position seriously given the number of ads and gullible people who will tell you how everything is a big pharma conspiracy and you can cure everything from a cold to cancer with enough {prayers, vitamins, water, ...}. Any supporting study would be better.

entee 9y ago

As someone who has worked tangentially to drug discovery and who has many friends who work as scientists in pharma, I promise you this is outright false. No scientist or even evil business/lawyer person for pharma is out to suppress known cures for disease in order to make a buck. This entirely leaves aside the notion that diabetes (abbreviating as DM2 for diabetes mellitus type 2) is a solved problem. If you can maintain a low calorie diet or a water fast, then yes you will improve and may not benefit from medication. The number of people who can do that sustainably is rather small, as evidenced by the number of people who get the disease in the first place. It's not like it's a mystery that excess caloric intake and weight gain are the major risk factors for DM2. It's also not a mystery to the patient, they know they should probably cut back a little, but it turns out that diets are extremely difficult to maintain long term. See: http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-trap.html http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-... So for those people who have difficulty maintaining drastic weight loss for whatever reason, I think it's ok to have a pharmaceutical industry that tries to find alternatives. If an individual patient can do without the drugs, that's great too. In the end, lives will be saved with both approaches, they are not in conflict.