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Nov 14

Diabetes is Prime Time

DiabetesIf you have watched very much television in the past twelve to eighteen months, you have almost certainly seen dozens, perhaps hundreds, of commercials for prescription medicines intended to treat diabetes. Think back, and you will realize that diabetes has replaced male sexual dysfunction as one of television’s most common advertising topics.

Ads for Viagra or Cialis have given way to products like Jardiance, Lyrica, Toujeo, Trulicity, Farxiga and Lantus. All of those latter products are aimed at treating some aspect of diabetes like blood glucose levels, A1C, or the nerve pain seen in diabetic patients (diabetic neuropathy). Why has this happened?

It is partly because the patent protection that Viagra and Cialis once enjoyed has expired, and drug companies do not pay to promote medications if they are not guaranteed an exclusive market. When that protection is gone, generic manufacturers will drive down the price and advertising will no longer pay off. That is true, but there is also a second reason—diabetes is a true “growth market.” In fact, it is one of the fastest growing markets in that market sector. From a business point of view, this is an opportunity; from a public health viewpoint, it is a disaster.

According to the Centers for Disease Control, diabetes is the 7th leading cause of death in the United States. It is the most common cause of kidney failure, adult blindness and lower-limb amputations. It is a hugely expensive disease; more than 20% of all health care spending in the United States is for people with known diabetes. Here is what a 2017 report from the National Institutes for Health said –

“Diabetes and its complications, deaths, and societal costs have a huge and rapidly growing impact on the United States. Between 1990 and 2010 the number of people living with diabetes tripled and the number of new cases annually (incidence) doubled. Adults with diabetes have a 50% higher risk of death from any cause than adults without diabetes, in addition to risk for myriad complications.”

Treating diabetes itself and those myriad complications is one of the main reasons that the cost of medical care (and medical insurance) is increasing so rapidly. If this trend is not halted, it will threaten the entire medical system.

There is a big irony in television’s “Diabetes is Prime Time” situation. If you sit through any given commercial break, you are likely to see at least one ad for “big, juicy burgers,” and then one for a product that treats diabetes or some consequence of diabetes. In many cases, eating too many of those fast food burgers for years has led to the need for drugs like Jardiance or Trulicity.

Many bariatric surgery patients are on one of those diabetes treatments. The good news is that weight loss surgery has proven effective in actually reversing diabetes and prediabetes. The Cleveland Clinic studied data on 252 diabetic patients who had gastric bypass surgery or gastric sleeve surgery between 2004 and 2012. All of these people were on insulin treatment before weight loss surgery. Prior to weight loss surgery only 10% of these patients met the American Diabetes Association’s blood sugar target. Seven years after their bariatric surgery, 59% met this target, half had stopped insulin with their diabetes under control and 15% were in permanent remission of type-2 diabetes.

If you are taking medication for diabetes and meet certain criteria like high body mass index and coexisting conditions such as heart disease, bariatric surgery may be an option for you. Only a thorough examination by a qualified weight loss surgeon can answer your questions. If you have any question about bariatric surgery or any other area included in general surgery, please contact our office. You may use Contact Dr Birkedal or phone us at (386) 210-9794. Our offices, located in Daytona, New Smyrna and Palm coast are all part of the Florida Hospital Network.

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