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Comment by Gatsky | Hacker News Reader

> In the United States, prescriptions to 18- to 49-year-olds with type 2 diabetes grew from fewer than 2200 in 2000 to 768,000 in 2015.

What the hell… that has to be a mistake? What is going on? Can poor lifestyle really cause this massive increase in young people with diabetes??

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It's an increase in a particular treatment for a disease, which is only a contingent proxy for the disease itself. A change on that scale could plausibly be explained by a change in the standard approach to treatment or diagnostic criteria. Wouldn't be surprised if insurance played a role somehow.

Treatment guidelines change all the time. Last time I checked metformin is now the the 1st drug therapy for type II diabetes and even "pre-diabetes".

It's basically "oh, your blood sugar might be an issue, let's start with metformin" where in the past it was "lets try a bunch of others things and just watch your levels for a bit"

This. I have a few family members who struggle with blood sugar levels. Their doctors are quick to turn to pills instead of lifestyle/diet and monitoring. Likely because lifestyle/diet changes are hard and not very successful. Most of them have managed to adapt and deal without the pills, but it does take regular monitoring and they're all still borderline (pre-diabetic, I think is the term).

Despite being used in Europe since the '50s, Metformin wasn't introduced in the US until 1995.

Ah right, that is surprisingly late, and would likely explain the numbers.

that doesn't say that diagnoses increased that much, just that this particular drug has become a much more popular way to treat it.

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