And Who Pays for This?

In a recent Nature article they indicate that the most recent recommendation for treating Type 2 Diabetes is surgical.

They state:

Clinical guidelines published this week announce what may be the most radical change in the treatment of type 2 diabetes for almost a century. Appearing in Diabetes Care, a journal of the American Diabetes Association, and endorsed by 45 professional societies around the world, the guidelines propose that surgery involving the manipulation of the stomach or intestine be considered as a standard treatment option for appropriate candidates. This development follows multiple clinical trials showing that gastrointestinal surgery can improve blood-sugar levels more effectively than any lifestyle or pharmaceutical intervention, and even lead to long-term remission of the disease

Let us examine some basic facts:

1. Type 2 Diabetes is a glucose metabolism malfunction. It is essentially an overpowering of the pancreas and its ability to maintain insulin secretion at levels to maintain safe glucose levels.

2. Glucose is  byproduct of carbohydrate intake and its breakdown. More carbs in the more glucose produced and the more stress on the pancreas and its ability to handle the load.

3. Excess carb intake leads to obesity. Obesity is thus a measure of this overload.

4. A BMI of 25 or less is generally a metric for good glucose control and it generally is reflective of HbA1c, the 60 day average glucose load.

5. Excess glucose also creates an excess free radical problem which in turn can result in a plethora of disorders including cancers.

6. To keep the glucose low one need only keep the carbs down and in turn the weight down.

7. A pound of added weight is an excess of 3500 Kcal of food intake. If one consumes 2,000 Kcal per day and has a BMR of 2,000 then the net is zero. If however the BMR is less then one starts gaining weight, usually reflective of a carb overload.

8. The zero costs solution is intake control and proper weight balance. It is really cheap, at zero.

Now the suggestion for significant invasive surgery are say a cost of $75,000 or more is insane. On the other-hand if the fattys get us old folks to pay for it then one guesses it is the ultimate gift of the ACA. And some candidates want free universal health care. Nothing is free folks!