Health care costs and diabetes

[Chuckanut]

Depending on how your figure it, 20 to 25% of the health care costs in the USA go towards treating diabetes and its complications.

Medical care takes almost 20% of the GDP.

So, if we could get a handle on diabetes prevention, we could reduce medicine’s chunk of the GNP by about and absolute amount of 4%. That would really help bring down the total cost of medical care and, I imagine, help pull Medicare out of its future financial problems. Right? Or am I missing something?

 

[Sarah S]

More insurance coverage for weight loss and lifestyle would help. Right now insurances are cracking down on prescriptions for ozempic which is the name semaglutide is prescribed for diabetes. They say ( I am sure correctly) it is being prescribed for people who are not diabetic because it is not covered as wegovy for weight loss.

Obesity is epidemic in the US 40% I believe 2/3 are at least overweight

As childhood obesity is a big issue addressing that in multiple ways would help too. Good healthy food is often more expensive than junk especially when time is limited. I believe physical education in schools has been cut. Nutrition education would eventually have some effect

 

[audreyh1]

Diabetes hazard can be detected way in advance by monitoring blood insulin as well as other markers of metabolic disease such as increased blood pressure and high triglycerides. By the time glucose control is lost a huge amount of damage has been done to the body. Blood insulin levels can detect an issue 20 years ahead!

But the medical community is way behind the curve ball on this and seemingly not motivated to change. It’s incredible how little progress has been made. Then there is the difficulty of convincing the patient to change their lifestyle, because this is generally a lifestyle disease. Much easier to attempt to manage it with drugs.

Cut the junk and processed food, cut the carbs including sugar, a lot can be reversed, but it’s still a big secret for some reason and counterproductive diets are still commonly prescribed, which is really a tragedy for those motivated patients.

 

[bloom2708]

It's the food.

When you see the incredibly varied food suggestions and ideas, it is no wonder diabetes will never go away.

Type 2 is a different animal from Type 1.

It is kind of same principle as "If only every member at church could give $X, this church would have so much money". It doesn't happen. 80-20 rule, etc.

 

[Aerides]

For the purposes of this discussion, I presume the OP is talking Type 2, vs. the genetic Type 1. One of the fittest looking people I ever knew was Type1.

Income is a big factor. Potatoes are much cheaper, and stay fresh longer, than broccoli. Same for cereal vs. eggs. Sandwich over a salad, etc.

 

[jollystomper]

Processed, unhealthy food is cheaper than healthy food, and gives one instant gratification.

Fewer people know how to cook. Some foods that are relatively healthy (or not as bad) when home cooked can become very unhealthy when purchased in stores.

In many low income urban areas, things such as fresh food markets have all but disappeared for a variety of reasons.

 

[Koolau]

Depending on how your figure it, 20 to 25% of the health care costs in the USA go towards treating diabetes and its complications.

Medical care takes almost 20% of the GDP.

So, if we could get a handle on diabetes prevention, we could reduce medicine’s chunk of the GNP by about and absolute amount of 4%. That would really help bring down the total cost of medical care and, I imagine, help pull Medicare out of its future financial problems. Right? Or am I missing something?

If we actually did get rid of diabetes, the "medical industrial complex" would absorb those savings and find other ways to charge us. Just like all the "help" the gummint gave kids to go to college, all that happened is that schools got fat, kids/parents went into debt and college costs went up to meet what kids could borrow.

 

[badatmath]

For the purposes of this discussion, I presume the OP is talking Type 2, vs. the genetic Type 1. One of the fittest looking people I ever knew was Type1.

Income is a big factor. Potatoes are much cheaper, and stay fresh longer, than broccoli. Same for cereal vs. eggs. Sandwich over a salad, etc.

Not diabetic but that whole staying fresh is a thing at least as much or more than price. I can shop much less often and not waste food if I get more crap. And I don't cook or have any interest in it. Lucky for me I manage to stay reasonably healthy by picking less horrible options . . .

 

[Rianne]

For the purposes of this discussion, I presume the OP is talking Type 2, vs. the genetic Type 1. One of the fittest looking people I ever knew was Type1.

Income is a big factor. Potatoes are much cheaper, and stay fresh longer, than broccoli. Same for cereal vs. eggs. Sandwich over a salad, etc.

Frozen vegetables are as good, maybe better than fresh. The vitamins are locked in at harvest. Fresh vegetables can sit in a truck for days before getting on shelves. Unless of course, you have a garden or frequent farmer's markets.

You don't have to be a super chef or creative cook to make awesome meals. Bean soup is very inexpensive to make. It's easy to add your own vegetables. Canned soups are filled with sodium, like any processed food which is kryptonite to diabetics. Added sugar too. There's nothing wrong with candy, ice cream, or a sweet every so often. The daily bad habits plague our country. A serving is a cup. That is so small. I eat giant salads from our garden. Fruits with the skin. Berries. All good.

 

[Koolau]

Processed, unhealthy food is cheaper than healthy food, and gives one instant gratification.

Fewer people know how to cook. Some foods that are relatively healthy (or not as bad) when home cooked can become very unhealthy when purchased in stores.

In many low income urban areas, things such as fresh food markets have all but disappeared for a variety of reasons.

All true, and the "time factor" comes into it as well. If both parents in a family w*rk and commute, it leaves little time to cook healthy meals. So much easier to grab a pizza on the way home or nuke one of the highly processed "one dish meals" like pot pies or Fettuccine Alfredo, etc. All very satisfying and filling and loads of calories/fat/etc.

 

[pacergal]

If we could get the corn syrup out of foods, it might help.
Getting folks back to "real food"--butter, raw sugar, etc instead of the more processed ones.
Teaching kids in school how to shop on a budget, buy groceries and cook would be wonderful--something they had when I was growing up a million years ago.

Early in my career, part of my nursing job was as a nutrition consultant for WIC(women, infants, children) recipients (food vouchers for pregnant women and kids up to age 5 for specific high nutritional value food)
So many women did not know how to cook beans, did not realize the frozen Furits/veggies were often less expensive than fresh, may last longer and just as good nutritionally. They would just keep choosing peanut butter for the protein coupon.
I shared so many recipes for beans, egg/veggie dishes, etc in order to encourage them to get other options. We even tried small cooking classes.

Obesity is a potential precursor to Diabetes, there are other factors besides diet that lead to obesity.

 

[JBTX]

Not diabetic but that whole staying fresh is a thing at least as much or more than price. I can shop much less often and not waste food if I get more crap. And I don't cook or have any interest in it. Lucky for me I manage to stay reasonably healthy by picking less horrible options . . .

I’m kind of the same way. Don’t cook a lot, just try to make more reasonable options if eating out, and monitor / track calories on an app and other inputs.

One great way to get and keep some fruits is to freeze them, and they are tastier frozen. Blueberries, raspberries, grapes, and bananas (sliced up) are great out of the freezer.

 

[cyber888]

I just succeeded in reversing Diabetes 2.
6 months ago, Doc said my A1C test was 6.5 - Diabetic.
I immediately switch to very low carb Keto diet and daily walks, and lost 16-18 lbs in 4-5 months.
Next time I went to see my Doc for a follow up blood work, A1C was down to 5.9. Pretty sure it's back to the normal (5.7) now as I monitor my blood glucose and I have averaged around 103-107 for months.
You just need to lose weight and belly fat.

 

[Koolau]

I just succeeded in reversing Diabetes 2.
6 months ago, Doc said my A1C test was 6.5 - Diabetic.
I immediately switch to very low carb Keto diet and daily walks, and lost 16-18 lbs in 4-5 months.
Next time I went to see my Doc for a follow up blood work, A1C was down to 5.9. Pretty sure it's back to the normal (5.7) now as I monitor my blood glucose and I have averaged around 103-107 for months.
You just need to lose weight and belly fat.

I'm w*rking on it too. My last A1C was up a couple of points. Still below 6.5 but not by much. I've been on either Atkins or low carb for a month and have lost 15 lbs. Amazing. My next test won't be for 4 months. I have hopes of maybe 6.0 or even less, but who knows. As long as it goes down, I'll be happy.

 

[ncbill]

Yep, but few will remain compliant with such strict dietary regimens.

Especially since the consequences are delayed for decades as mentioned.

So we need increased coverage for appetite suppresants such as Ozempic/Wegovy & Monjuro .

 

[Gremlin]

That is an amazing achievement! Congratulations.

I just succeeded in reversing Diabetes 2.
6 months ago, Doc said my A1C test was 6.5 - Diabetic.
I immediately switch to very low carb Keto diet and daily walks, and lost 16-18 lbs in 4-5 months.
Next time I went to see my Doc for a follow up blood work, A1C was down to 5.9. Pretty sure it's back to the normal (5.7) now as I monitor my blood glucose and I have averaged around 103-107 for months.
You just need to lose weight and belly fat.

 

[Gremlin]

That’s fabulous! Fingers crossed for better numbers.

My husband dropped 40 pounds on the keto diet. For his starting weight, that was more than we wanted him to lose. Our neighbor asked me if he had cancer! So we loosened our low carb restrictions and he gained back to a better weight and has maintained it since.

I'm w*rking on it too. My last A1C was up a couple of points. Still below 6.5 but not by much. I've been on either Atkins or low carb for a month and have lost 15 lbs. Amazing. My next test won't be for 4 months. I have hopes of maybe 6.0 or even less, but who knows. As long as it goes down, I'll be happy.

 

[cyber888]

I'm w*rking on it too. My last A1C was up a couple of points. Still below 6.5 but not by much. I've been on either Atkins or low carb for a month and have lost 15 lbs. Amazing. My next test won't be for 4 months. I have hopes of maybe 6.0 or even less, but who knows. As long as it goes down, I'll be happy.

Congrats on losing weigh Koolau. As long as you keep moving, you should be fine. I'm down 20 lbs now, and prepare my own low carb food, my zero carb tuna sandwich, and my low carb pizza. I try to walk 30 - 60 minutes everyday

 

[cyber888]

That is an amazing achievement! Congratulations.

Thanks Gremlin. My routine is becoming second nature now, eating low carb, high protein, eggs, exercise, walking, avoiding any sugar, starchy food, and counting carbs

 

[6miths]

Corn syrup is not the problem. I recall having corn syrup in a can as a kid. It was pretty unappealing but occasionally stooped to eating it on toast when was out of honey or jam or anything else with sweet 'sugar' (i.e. sucrose or fructose) in it. Corn syrup is just starch (glucose polymer) and when broken down a bit the free glucose amount increases and makes it somewhat sweet but not like what we have today. Some joke that it was the revenge of the Japanese when 20 years after losing WW2 they invented the process that converts boring corn syrup to HFCS. Better living through chemistry - the somewhat sweet glucose is converted to the super sweet (and potentially toxic) fructose. And the stage for the obesity and T2DM epidemic was set. What really got it rolling though was the 'fat is bad' message that stuck from the 1972 Dietary Guidelines (which also said avoid sugar) but hard to avoid both so fats and cholesterol became public health enemy number 1.

Also Type 2 diabetes is much more strongly a genetic (familial) condition than Type 1 diabetes is.

As others have said, drugs are not the answer. 'An ounce of prevention is worth a pound of cure'. Need to get back to eating decent diets in reasonable amounts. You want to do one thing to avoid T2DM - don't eat sugar - cane sugar, beet sugar, HFCS or any one of the 64 other names. And while you are at it stay away from any highly refined starch.

 

[Retired Expat]

All true, and the "time factor" comes into it as well. If both parents in a family w*rk and commute, it leaves little time to cook healthy meals. So much easier to grab a pizza on the way home or nuke one of the highly processed "one dish meals" like pot pies or Fettuccine Alfredo, etc. All very satisfying and filling and loads of calories/fat/etc.

Where we live there is little to none packaged frozen meals and no delivery what so ever. Hence I cook most days. Or when I cook I make sure there is left overs for a second meal. It rarely takes more than 30 minutes to get dinner on the table. Grilled meat or chicken and a bunch of veggies. On a Saturday I might prep enough veggies for the week. Par cook some rice or pasta to finish off quickly. Lots of salads too.

Too many people are afraid of cooking but it really is easy and fresh ingredients not overcooked usually always taste great. Invest in a pantry full of seasoning or some seasoning blends and a few jars of better than bullion to kick up the flavor.

Oh and cooking is so much cheaper in the long run