The Diabetes Cure That Most Insurance Companies Won't Pay For

The article keeps calling this a "cure" to diabetes. If anything, it's a cure to the "never feeling full" sensation that leads some (usually mildly autistic) people to constantly eat. And this constant overeating is what leads to the diabetes.

Having known people who had gastric bypasses, it's far from a miracle cure. The procedure causes many issues, from intestinal discomfort to life-threatening complications. Treating the procedure with such rose-colored glasses could be considered harmful.

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Part of the reason nobody wants to pay for it is it costs as much as a Model 3:

> The estimated average cost of bariatric surgery is around $15,000, according to a 2017 review. But even these estimates might be underselling it. Benari recalls that his surgery, with expenses before and afterward, was about $35,000 without insurance. The price tag kept him from pursuing the procedure for almost a decade.

And an interesting reaction - the person briefly considered gaining 40 pounds, but instead of considering losing 40 pounds, they guilt-tripped their employer into paying for it.

> “Obviously I couldn’t gain 40 pounds so I could get surgery—that’d be suicidal. I just held off, trying to not think about it,” he said. “Eventually, through a lot of back and forth, nagging and whining, I convinced [Microsoft’s] HR department to overhaul their policy and allow people in my situation to get the surgery done.”

That's not because of the surgery. It's because he was forced into an extended fast before (and after) the surgery. Type 2 diabetes reverses almost immediately with fasting.

I have no personal involvement with Dr. Jason Fung's clinic in Canada, but he claims to reverse type 2 diabetes in virtually every case. https://idmprogram.com/

Reversal: what is being described here. Symptoms go away, and the longer you pursue the treatment, more difficult it becomes to clinically determine you ever had the metabolic disorder in the first place. However, the latent characteristics that made you first susceptible still exist.

Cure: you not only reverse, but you could stuff your face with pizza and Ho Ho pastries, wash it down with a gallon of Mountain Dew, and your blood sugar hardly budges, like normal people.

We do not have a cure. Short of genetically rewiring in vivo, or similar advancement, we won't see a cure. However, ongoing improvement of our understanding of how our bodies work continue to make it simpler than ever before to reverse Type 2. Simple doesn't mean easy, though.

Put another way: is gastric bypass a way of solving the psychological problem of eating too much, the lack of will to stop eating?

I sure hope for people who undergo this surgery do see an improvement. I just hope they got briefed on how they could try without it before having their stomach mutilated. This article does a very bad job of it. As if the surgery were a miracle cure.

Oh, so the "cure" was to make sure his body consumes/processes less calories? And this is considered some novel solution? Is this a joke?

And then there's this technically accurate but misleading sentence - "But Benari, now 44, was a very unusual patient in one clear way: He wasn’t obese." True. He wasn't obese. But he was overweight - "Benari’s BMI before he underwent the surgery hovered around 28, which made him modestly overweight but not obese." Being overweight or obese is a textbook sign of being a diabetic, pre-diabetic, or at-risk for diabetes, as your metabolic functions are most likely comprised to at least some degree which results in the symptom of excess weight. The article tries to mislead the reader to thinking that because he wasn't technically full blown obese by clinical definitions he was somehow an exceptional outlier. Nonsense.

This man was clearly consuming too much food or food other than carbs that also results in blood sugar spikes (excess protein is metabolized in much the same way), which is why the restriction of caloric intake worked for him. The part at the beginning about him being restricted from "most carbs" seems irrelevant in that context, especially when you factor in the knowledge that he was already confirmed to be compromised and a full blown diabetic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936261/

Abstract

Bariatric surgery is now widely reported to ameliorate or resolve type 2 diabetes mellitus in adults. Some clinical investigators even suggest its use as an early therapeutic intervention for type 2 diabetes in patients not meeting standard criteria for bariatric surgery. However, little is known about the exact mechanisms explaining the metabolic consequences, and much active investigation is underway to identify hormonal changes leading to diabetes resolution. This review includes a detailed description of various bariatric surgical procedures, including the latest less-invasive techniques, and a summary of current data providing insight into the short- and long-term metabolic effects. We outline current hypotheses regarding the mechanisms by which these surgical procedures affect diabetes and report on morbidity and mortality. Finally, we discuss the available data on bariatric surgery in adolescent patients, including special considerations in this potentially vulnerable population.

https://www.sciencedirect.com/science/article/pii/S019697811...

Abstract

Bariatric surgery for obesity has proved to be an extremely effective method of promoting long-term weight reduction with additional beneficial metabolic effects, such as improved glucose tolerance and remission of type 2 diabetes. A range of bariatric procedures are in common use, including gastric banding, sleeve gastrectomy and the Roux-en-Y gastric bypass. Although the mechanisms underlying the efficacy of bariatric surgery are unclear, gastrointestinal and pancreatic peptides are thought to play an important role. The aim of this review is to summarise the effects of different bariatric surgery procedures upon gastrointestinal and pancreatic peptides, including ghrelin, gastrin, cholecystokinin (CCK), glucose-dependent insulinotropic hormone (GIP), glucagon-like peptide 1 (GLP-1), peptide YY (PYY), oxyntomodulin, insulin, glucagon and somatostatin.

I know many people who have had them, and in every case they'd describe it as having traded one problem for another.

While fasting in various forms may be beneficial and less harmful than hacking out a significant part of your digestive system we must acknowledge the psychological barrier faced in doing so.

As someone who has successfully fasted repeatedly combined with regular exercise solely for weight control, the effort is quite "character building" and simply expecting diabetics and the obese to engage in what amounts to self denial just because it is the correct approach is quite unrealistic.