Megabucks for Crisis Care, Pennies for Prevention

Economics of Diabetes
Daily Health News.
When it comes to type 2 diabetes, an ounce of prevention is worth a ton of cure. This disease, characterized by high levels of blood sugar (glucose), has now reached epidemic proportions. In fact, the Centers for Disease Control and Prevention (CDC) estimates that one in three children born in 2000 could develop it if they don't change their ways. Despite this rise, a series inThe New York Times in early 2006 pointed out that dedicated diabetes care centers are shutting down -- not because they are unsuccessful in combating diabetes, but because they are not making money. So, what's a diabetic to do? If it's not profitable to stay well, are they forced to get very sick so that they can then be treated? Or, is it that staying well is a matter of personal choice and responsibility? It appears that the economics of wellness may indeed be sending the message of "do it yourself" health.
The problem is that American health-care dollars flow mainly toward acute, last-minute, lifesaving crises, rather than toward primary care and prevention. While it is not profitable for the health-care industry to provide preventive care for chronic diseases such as diabetes, it is hugely profitable to treat their acute complications. It has been reported that diabetes care centers lose tens of thousands of dollars per year teaching patients to monitor their sugar levels, follow a healthy diet and get regular exercise -- strategies that would keep diabetes under control and prevent complications. Conversely, $30,000 amputations -- which occur when diabetes spirals out of control -- are very profitable for hospitals.
According to Ray D. Strand, MD, author of Healthy for Life (Real Life), the US health-care system relies too heavily on money-making high-tech and pharmaceutical interventions. Conventional medicine is great at opening up an artery with a stent or curing a raging infection with penicillin... but when there's no operation or pill to cure a disease, individuals are left scrambling. When it comes to diabetes, he believes that modern medicine focuses too much on drugs and procedures to address its consequences, and pays too little (and sometimes no) attention to one of the underlying problems -- insulin resistance.
Insulin resistance -- in which the body can no longer make proper use of insulin and correctly process glucose and fat stores -- is the precursor of diabetes, when blood sugar is higher than normal but not yet high enough to be diagnosed as diabetes. This condition is the result of poor lifestyle choices, primarily a diet of fast and processed foods, a lack of exercise and obesity. If you do nothing to make better choices, Dr. Strand warns that the scales will eventually tip and you will develop metabolic syndrome -- a devastating combination of prediabetes, abdominal obesity and high triglyceride levels, high LDL and low HDL cholesterol levels, and high blood pressure. It affects 25% of American adults.
There is no Food and Drug Administration-approved pill to cure insulin resistance, notes Dr. Strand. This may be why modern medicine largely ignores it -- it's the "where there's no pill, there's no disease" way of thinking. However, he stresses that in most cases you can reverse insulin resistance and prevent diabetes by changing your lifestyle and consistently making healthier choices. Even if you already have diabetes, positive strategies such as a proper diet and regular exercise will help you manage it more effectively and prevent complications.
Type 2 diabetes doesn't develop overnight, observes Dr. Strand. It is the product of years and years of unhealthful lifestyle choices. The sooner you address and correct lifestyle issues, the better chance you have of reversing or avoiding insulin resistance and diabetes. Dr. Strand recommends...
  • A healthful diet that does not spike blood sugar. Conventional doctors don't appreciate the science of the glycemic index, and feel that a carb is a carb is a carb, explains Dr. Strand. Not so. The glycemic index is a ranking of foods according to how rapidly there is a rise in blood sugar. (Read more about it in Daily Health News,September 20, 2004.) Dr. Strand recommends that you choose low-glycemic index foods, such as many fresh fruits and vegetables, lentils and oatmeal, which trigger only a modest rise in blood sugar and enter the bloodstream slowly. Likewise, avoid high-glycemic foods (potatoes, cornflakes, white bread, doughnuts, etc.) that send blood sugar soaring.
  • A moderate, consistent exercise program. To get started, just dust off your walking shoes and take a walk around the neighborhood. Over time, work your way up to 30 to 40 minutes of aerobic exercise (for example, brisk walking or bicycling) five days a week. For consistency and accountability, it helps to buddy up with a friend or join an exercise group.
  • High-quality nutritional supplements. According to Dr. Strand, most conventional physicians do not appreciate the use of nutritional supplementation, which has a great benefit in pre-clinical diabetes and diabetes. To boost cellular nutrition, he advises that you take a high-quality antioxidant (vitamins C and E are among his favorites) with each meal. Other helpful supplements include chromium, magnesium and selenium.
Note: Read more about Dr. Strand's program to reverse insulin resistance at He has just completed a clinical trial in which all 25 pre-clinical diabetic participants were able to reverse their insulin resistance within 12 weeks.
Instead of offering patients an opportunity to address their health with lifestyle changes, physicians are too quick to simply write a prescription, notes Dr. Strand. The bottom line is there's not much profit for the health-care industry with changes in diet and exercise. However, these lifestyle changes can return your body to health -- turning around insulin resistance, holding diabetes at bay and reducing or even eliminating the need for drugs and other interventions. As I have written about many times, the same holds true for many health challenges, from arthritis to allergy, and gastritis to heart conditions. Medical science has done many great things for the health of our nation, but they are missing the mark when it comes to simple preventive measures. Individuals must take control of their own lives. Prevention and lifestyle changes are still cheaper no matter what, even if insurance doesn't cover them. And, while it's easy to get mad at the insurance companies for not covering some of those measures, keep in mind that insurance is really for "the big stuff" -- you don't need insurance to pay for you to eat right and take a walk each day.

Be well,

Carole Jackson
Bottom Line's Daily Health News