The bittersweet Diabetes economy

In 1997, a group of experts convened by the American Diabetes Association changed the definition of type 2 diabetes, lowering the blood sugar threshold, and instantly as many as 1.9 million more Americans had the condition.

The same pattern played out in 2003, in an even bigger way, when the association changed the definition of a condition known as pre-diabetes and — overnight — 25 million more Americans were affected.

In the decade that followed, the diabetes industry boomed — thanks in part to a 2008 declaration by two endocrinology groups that pre-diabetes could be treated with drugs if diet and exercise didn’t lower blood sugar.

Last year, sales of diabetes drugs reached $23 billion, according to the data from IMS Health, a drug market research firm. That was more than the combined revenue of the National Football League, Major League Baseball, and the National Basketball Association.

But from 2004 to 2013, none of the 30 new diabetes drugs that came on the market were proven to improve key outcomes, such as reducing heart attacks or strokes, blindness, or other complications of the disease, an investigation by MedPage Today and the Milwaukee Journal Sentinel found.

The U.S. Food and Drug Administration approved all of those drugs based on a surrogate endpoint: the ability to lower blood sugar. Many of the new drugs have dubious benefit; some can be harmful.

“We have an entire industry — a diabetes economy — that revolves around glycemic control,” said David H. Newman, MD, director of clinical research at Icahn School of Medicine at Mount Sinai Hospital in New York…

We’ve called a sign of the disease the disease, but there are no rigorous studies that prove we understand how to treat the illness rather than its symptoms,” Newman said…

To be sure, type 2 diabetes — once known as adult-onset diabetes — is a serious problem in America, often requiring drugs. The condition can lead to cardiovascular disease, kidney failure, amputations, and more immediate symptoms, especially in those with very poor glycemic control.

The surging number of cases has closely paralleled increasing rates of obesity, sedentary living, and an aging population.

But the number of people with diabetes or pre-diabetes and who are candidates for drugs has been magnified by organizations and doctors with financial ties to drug companies…

RTFA and follow the Money Trail.

As often as my political opinions have indicted what President Eisenhower called The Military-Industrial Complex – as individuals searching for honesty in politics and economics, we need to spend more time confronting the Medical-Industrial Complex.

One of those delightfully-American diseases for which there is no cure; but, an enormous profit center grounded in treating symptoms for the rest of your life.

3 thoughts on “The bittersweet Diabetes economy

  1. Nikohl Vandel says:

    You know, i wondered about this when i was pregnant. I did what i was told as i was completely overwhelmed and the problem was easily solved for that short period of time with insulin.

    Of course, now I’ve learned all about this game of defining diabetes and diseases in general. I learned, for diabetes (especially in pregnancy) there are all kinds of other options never once mentioned or discussed. And i went to a midwife.

    Imho, we could use some more whistle blowers coming out of the medical industrial complex talking about the system of disease creation/management income streams.

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