The Diabetes Gold Rush

Lou came into the office. Clearly, his program had gone sour.

Lou had initially obtained wonderful control over his heart scan score of 1114, having reversed modestly in his first three years of effort through correction of his multiple causes (including low HDL, severe small LDL, Lp(a), and a diabetic tendency).

But Lou now came into the office red-faced and sporting a big bulging abdomen. Blood sugar? Now in the overtly diabetic range. Lou said that his primary care doctor had suggested that he start on three new medications (glucophage, injectable Byetta, and Actos) to control his blood sugar. His doctor also told him to increase his intake of fibers by eating more "healthy" breakfast cereals like Cheerios.

Lou had apparently done just that (added "healthy" fiber-rich foods) even before his doctor had suggested it. (Lou failed to remember the several conversations we'd had about healthy eating.) Unfortunately, Lou also failed to connect his increased intake of "healthy fiber-rich foods" and his growing abdominal girth (his "wheat belly").

Here's the dirty little secret: Much of the world wants you to be diabetic. It is the health gold rush of this century. "Go West, young man!"

To find out what I mean, you need only ask: Who profits when people become diabetic? That's easy:

The pharmaceutical industry--Diabetes is a booming growth industry, a source of tens of billions of dollars of revenue, poised for enormous growth as the population ages and gets fatter. It is common for a newly-diagnosed diabetic to be given new prescriptions for two or three drugs with a monthly cost of $300. Of course, the chronic nature of the disease make this far more profitable than, say, a two week course of antibiotics. Presently, 70 new drugs are under development.

Diabetes drug maker Novo Nordisk reported a 25% increase in revenues in 2007 from diabetic agents in the North American market, along with near $2 billion increase in profit for the year. Merck's recently-released DPP-4 inhibitor, Januvia, has already sold $668 million in 2007 and is growing rapidly.

The medical device and supply industry. Take a look at the Medtronic quarterly earnings report, detailing the breakdown of their record-setting quarterly revenue of $3.7 billion:

Diabetes revenue of $269 million grew 12 percent driven by sales
of consumables, the accessories required by insulin pump users, and
continuous glucose monitoring products. Revenue from international
sales grew 31 percent over the same quarter last year.

That's what I call a growth industry.

The processed food industry. The food industry is as big or bigger than the drug industry. ADM, Kraft, General Mills all have annual revenues in the $12-50 billion range. There are plenty of others.

When we're told, for instance, that Cheerios reduces cholesterol, we're not told that it skyrockets blood sugar or triggers small LDL. When we're sold whole wheat crackers, Cocoa Puffs (which the American Heart Asscociation says is heart-healthy), or granola bars, hunger is stimulated, impulse to eat more grows, blood sugar escalates, we get fat, we get diabetic. It's a simple formula.

So be aware that there is little incentive among corporate giants in the food, medical device, or drug industries to encourage behaviors that decrease the incidence of diabetes. In fact, there is enormous financial incentive to make sure that diabetes continues to grow at the startling rate it has over the last decade.

To be sure, the drug and medical device industry will also develop better tools to deal with diabetes and its complications. But the very best way to deal with diabetes is to not develop it in the first place.

Comments (9) -

  • Anonymous

    9/11/2008 11:53:00 PM |

    while you mention a low fat diet in your book, you now seem to speak of a higher sat fat diet, but how high?  also, it appears that oatmeal and oat bran are recommended by you to be good.  Is this correct?  I thought grains should not be consumed

    It would be helpful to those of us who have read your book to have a current picture on your diet recommendations as they currently stand.  thank you for the fine blog you produce.

  • Dr. William Davis

    9/12/2008 1:03:00 AM |

    Hi, Anon--

    The new Track Your Plaque Diet will be coming out in both the website, as well as the revised version of the book, likely out in 2009. This will include all the new strategies we've been employing.

  • Anna

    9/12/2008 3:53:00 AM |

    Have you thought about an e-book?  Would make updates much easier.  I'd get it and recommend it (I do have the TYP book).

  • Ricardo Carvalho

    9/12/2008 3:53:00 AM |

    Dear Dr. Davis, I believe your post demonstrates a lot of courage and personality by recognising that the pharmaceutical, medical and food industries are more worried about their profits than about promoting health among our society. We already knew this, of course, but it is different when it’s said by a doctor. In Portugal, in 2006 an estimated 6.5% of the population was diabetic. In the last 7 years, the number of diabetics increased an amazing 40%! Also, it is estimated that there are thousands more undiagnosed cases, so the total number today can be around 1 million (10% of the population). This is the 4th cause of death in Portugal and cardiovascular disease is 1st. Some of these cardiovascular deaths might be related to diabetes, isn’t it? In my opinion, this is a total catastrophe requiring urgent mobilization from all sectors of our society! But, unfortunately, most authorities don’t seem worried at all about preventing this. After all, their profit is proportionally higher to people’s ignorance. I also notice that some, or most(?), doctor simply don’t have a clue about what is healthy food, glycemic control, low-carb or paleolithic diets, etc. Also, total cholesterol is still considered the number one problem, when perhaps glycaemia is much more relevant to public health. The spouse of a friend of mine, who is a nephrologist, says that “doctors are just mechanics”, so I assume they really don’t care about avoiding the engine’s damage, but only about repairing it. I think this shouldn’t be like this. We want preventive medicine! I once made a rough estimate of diabetic related deaths in Portugal - and this can be far from reality -, and it was about 5.000 people/year. Too many deaths and human suffering that could be avoided! How many people will die in our country because of terrorism, carjacking, assaults, and so on, the major concerns in the media? I don’t have the statistics but certainly very few. Metabolic disorder induced diseases, like cardiovascular disease and diabetes, will kill many thousands and should be world’s priority number one. People perhaps think this is inevitable, something decided by the external forces of destiny. But it’s not, proper lifestyle changes can make a tremendous difference. I personally believe in emulating the traditional and ancestral ways of living: something like a paleodiet, caloric restriction, unprocessed foods, no refined sugars, minimal amount of cereals & dairy, being active, walking & running, etc., the so called Primal Blueprint ( I don’t want to make this comment be larger so I’m stopping here. I finish this comment with a few book suggestions from my Amazon Listmania:

  • Anne

    9/12/2008 10:49:00 AM |

    And don't forget all the gold in taking care of diabetic complications from inadequately controlled blood glucose. What would happen to that industry if people followed guidelines of Dr. Bernstein or read Blood Sugar 101?

  • steve

    9/12/2008 7:26:00 PM |

    glad to hear there will be a revised edition of the track your plaque book updated for current knowledge.  Will that be early '09 and in the meantime other than elimination of grains where in the low carb universe is best for fighting heart disease; sat fat matters, and should be low, or don't worry about it.  Thank you.

  • Anonymous

    9/13/2008 1:00:00 PM |

    I'll wait for your new book but I am perplexed that a vegetarian diet, by implication, would be unhealthy.

  • Peter Silverman

    9/17/2008 3:19:00 PM |

    I can't understand why people who ate the traditional Asian diet, mostly rice, had such low rates of diabetes and heart disease.

  • Steve Cooksey

    2/7/2010 8:40:14 PM |

    Dr.  Davis,

    This post means SO MUCH to me.

    I am a paleo diabetic... no meds, no insulin (lost 75 lbs) .

    I have been saying the same thing ... and now I know I am on the right track.