Philip J. Goscienski, M.D.
July 2009
Two hundred-eighteen billion dollars might not seem like much in a multi-trillion dollar budget. That's our annual bill for type 2 diabetes, a disease that should not exist. A couple of generations ago physicians called it adult-onset diabetes in order to distinguish it from juvenile diabetes, whose cause and course were completely different from the former.
The disease that physicians encountered only among their older patients in the middle of the last century is perhaps the fastest-growing and soon to become the most common chronic disease in the history of mankind. Several factors will unequivocally make it the most expensive. One element is its reach down into pre-teen children. In 35 years of pediatric practice I never encountered a child with type 2 diabetes. Now, in many metropolitan children's hospitals, half of their diabetic patients have the type 2 form.
Diabetes' complications are costly because they are debilitating but not quickly fatal. Its victims can live for decades in spite of losing their vision and a leg or two. Kidneys fail but dialysis postpones death. The heart disease and strokes that are so common among diabetics are quite manageable thanks to modern medicine although their victims don't have much in the way of quality of life.
The indirect costs are hard to measure exactly. How does one calculate the loss of future income of the 18-year old type 2 diabetic who might survive 3 or 4 more decades? Instead of generating a couple of million dollars' income in a 40-year career he or she will generate more than that in medical costs.
Diabetics beget diabetics. Studies of the Pima Indians of our own Southwest show that children of obese, diabetic women are very likely to become obese, diabetic adults with a high incidence of kidney failure early in life. The obesity/diabetes trend among Americans is increasing, not decreasing. Affluent America is only a couple of generations behind the Pima model.
We can prevent type 2 diabetes but we cannot cure it. Prevention is simple; it's not easy. Persons with normal levels of body fat and who avoid regular high levels of blood sugar almost never develop type 2 diabetes. From early childhood we need daily, moderately intense physical activity and a diet high in plant foods and low in refined grains and sugar.
It's not easy, it's just worth it.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.