Diabetes, a growth industry

Philip J. Goscienski, M.D.

January 2009

If you watch TV for more than a couple of hours each day you have probably viewed several commercials that pitch products or services for patients with type 2 diabetes. An entire new industry is growing up to serve the more than 20 million Americans who suffer from a disease which was extremely rare a century ago. Considering that the disease afflicts an estimated 10 million additional persons who are not yet aware of their condition, this is one industry that has nothing to fear from an economic downturn, now or in the next several decades.

The stage for type 2 diabetes is set even before birth. If a pregnant woman has the disease, or even the transient form known as gestational diabetes, it's likely that her infant will acquire it during his or her adult life. The well-studied Pima Indians of our own Southwest provide us with a preview of the future: early onset during adolescence and a life shortened by heart disease and kidney failure. Blindness and amputation add to the misery.

The pharmaceutical industry is well aware of the profit potential of type 2 diabetes. It receives a large share of the nearly 100 billion dollars per year required for diabetes care. Each patient spends hundreds of dollars per month in drugs that slow the process down but do not cure it.

To my knowledge there is no pharmacy that specializes in heart disease, the leading cause of death in America, or allergy, a condition that afflicts about one-quarter of us. But now there are pharmacies that specialize in the needs of persons with diabetes, the vast majority of whom have the lifestyle-induced variant that we used to refer to as adult-onset diabetes.

A spokesman for one of these pharmacies states that the firm is growing at the rate of about 20 percent per year. Ordering supplies and equipment online is as easy as ordering a book from Amazon.com.

For patients who prefer face-to-face contact with a pharmacist, neighborhood sites are mushrooming. There are two new facilities each within 15 minutes from my home in my relatively small community. They combine personal service with the latest technology that reduces errors and fills prescriptions in record time. There's no need, of course to bring along a book or magazine; you won't be kept waiting.

There is no counterbalance to the financial forces that drive the diabetes industry. The amount of money for programs that would educate women of childbearing age to avoid diabetes — a move with multigenerational benefits — is vanishingly small. Children now in elementary school, more than one-third of whom will suffer from type 2 diabetes in middle age, according to the Centers for Disease Control and Prevention, learn little about avoiding obesity and diabetes. Physical activity among adolescents continues to decline although some require insulin for their type 2 diabetes by the time they graduate from high school.

By the year 2020 the annual bill for the treatment of type 2 diabetes will be about one-quarter trillion dollars. What a waste!

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.