
The Diabetes Cure That Most Insurance Companies Won't Pay For - victorbojica
https://gizmodo.com/the-diabetes-cure-that-most-insurance-companies-wont-pa-1826946364
======
stephengillie
> _In May 2016, however, Benari received a procedure known as a gastric
> bypass, a laparoscopic surgery that gave him something few of the 30 million
> diabetic Americans ever have—a life free of insulin therapy and other
> medications._

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.

\---

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.”_

~~~
martin_bech
Nope it really is a cure. I know people involved with diabetes research, and
it really is a cure, and they dont know why. Its not because of the weight
loss, because it is instant! They day the get the surgery, the loose the
Diabetes II. (The people I know, work at Novo Nordisk, i would think its the
world leader in diabetes and diabetes related research.)

~~~
kmundnic
What if they gain weight again, months or years after surgery? Does diabetes
come back?

~~~
martin_bech
Im not doing the research, so I cant answer, but it dosent seem to be weight
related, as they loose the diabetes on same day as surgery. They loose none of
the weight on surgery,

------
zerohp
> “My diabetes went into remission basically immediately, almost that same
> day. And I’ve been off insulin for about 8 months now,”

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/](https://idmprogram.com/)

~~~
aviv
Exactly. Fasting cures diabetes as well as a host of many other "incurable"
"diseases". But there is no money in fasting, so our messed up world continues
to reject it as a valid solution.

~~~
Dirlewanger
Sad that people are already downvoting you, and sad that more people don't
know about other options than medication/surgery.

Here's a link to Dr. Fung's article specifically on reversing type 2 diabetes
([https://idmprogram.com/reverse-type-2-diabetes-the-quick-
sta...](https://idmprogram.com/reverse-type-2-diabetes-the-quick-start-
guide/)).

Keep downvoting me too, Big Pharma.

~~~
throwaway5752
People are downvoting the parent to your comment because of the _" a host of
many other "incurable" "diseases"_ part. It's unsubstantiated and unspecific,
and it jumps right to conspiracy theory.

People are downvoting you because you are violating at least 3 site guidelines
(commenting about voting, alleging astroturfing/shillage, and being civil).
Particularly when you could have made a constructive argument and tried to
elaborate what conditions it cured, what studies were behind it (maybe
summarizing Dr. Fung's research), or other more valuable contributions.

~~~
JakeTyo
These are probably the same people who think CNN is "fake news".

------
cadamson
This is clickbait at best, and isn't a cure for Diabetes. Yes it will help a
very small fraction of those that suffer from Type 2, but on the whole the
article (title especially) is very misleading.

------
iamt2
There is a distinct difference between Type 2 diabetes "cure" and "reversal".

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.

~~~
simonsarris
> wash it down with a gallon of Mountain Dew, and your blood sugar hardly
> budges, like normal people.

If by "normal people" you mean "pre-diabetic", maybe.

Any cure to snake bites requires not getting bitten again.

------
21
Is drastically restricting the amount you eat equivalent to gastric bypass? Or
is there something more?

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

~~~
Pete_D
There could be more to it. There's a hypothesis that microbiome changes could
be a contributing factor[0].

Restricting food intake is similar in that it reduces stomach capacity[1],
though almost certainly not as drastically as surgery. Lots of people have
already mentioned fasting in this thread; I'll add an anecdote that for a few
days after a fast, I get full _much_ more quickly.

[0] [https://biodesign.asu.edu/news/dramatic-shift-gut-
microbes-a...](https://biodesign.asu.edu/news/dramatic-shift-gut-microbes-and-
their-metabolites-seen-after-weight-loss-surgery)

[1]
[https://www.ncbi.nlm.nih.gov/pubmed/8561056?itool=EntrezSyst...](https://www.ncbi.nlm.nih.gov/pubmed/8561056?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1)

------
BlakePetersen
Dang. I was hoping they perfected pancreatic beta islet transplantation...
That is a terribly misleading title and a major click-bait let-down for Type
1s hopeful for an _actual_ cure for diabetes.

------
lolc
As a type 1 diabetic myself I'm highly skeptical of the claims. There is wide
consensus that most people with type 2 diabetes could reverse it if they
changed eating habits and exercised more. In fact many do! Those that don't
could possibly profit from a surgery. But that's admitting defeat really.

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.

------
turc1656
"The net result is that less food can fit in the stomach, and there’s much
_less time for that food to be turned into calories_ before it exits the body.
The vertical sleeve gastrectomy, the most popular surgery in recent years,
only tinkers with the stomach, using staples to turn it into a small banana-
shaped organ."

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.

~~~
scarface74
_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."_

BMI is a poor measurement for obesity. Especially without knowing his body
makeup.

When I was in the best shape of my life - a part time fitness instructor,
worked out 10 hours a week between classes and my own workouts, and at one
point I was down to a 29 inch waist, my BMI was 29.6 - borderline obese -
according to the guidelines. I was muscular, toned, and could pass any of the
standard physical fitness tests (military, police, etc.)

Currently according to the BMI guidelines, I’m “obese” with a BMI of 30.72 and
I should weigh 35 pounds less than I do now. I wear a size 33 pants (waist).
At most, I want to lose about 10 pounds or one waist size.

------
xinyhn
This is a good review of current understanding of the effects for anyone
interested in more than some of the comments so far.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936261/](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...](https://www.sciencedirect.com/science/article/pii/S0196978115002454)

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.

------
_raoulcousins
I looked into getting it, and the doctor's office was surprised that my
insurance didn't cover it. They said that the usual version of my plan
normally covers it but my employer had a stipulation that specifically
excluded weight loss surgery. $15k out of pocket if I want to do it. I
probably should.

------
jstewartmobile
This piece has the stench of public-relations ghostwriting all over it.
Describing a gastric bypass as a "cure" for anything is fake news if I've ever
heard any.

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

------
flocial
I share the general sentiment of shock in the comments that such a sensational
click bait article somehow made it to the front page. A healthy diet with
regular exercise might always be the correct answer but this is exactly the
kind of problem that would benefit from hacking.

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.

------
techiferous
I was totally expecting the cure to be a gym membership. Exercise is still the
gold standard of care for managing type 2 diabetes.

------
buckthundaz
Imagine consuming less sugar and less carbohydrates, and food at more
infrequent intervals...

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bitwize
Why even bother with the surgery? Real hackers fast intermittently, and eat
strict keto otherwise.

~~~
cosmojg
Lack of willpower perhaps?

~~~
shadykiller
Completely agree. My father is a T2 diabetic. He tried keto with great results
but could not sustain it. Recently he tried fasting and started getting
similar results. Stopped insulin altogether from his peak of 30 units a day.

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aviv
Diabetes can already be cured, without the sick concept of a gastric bypass as
some sort of a solution. Type 2 diabetes can be completely reversed following
a 14 to 40 day water fast or a series of short 4-7 day dry fasts. This is
complete insanity that such a simple solution is still not mainstream in 2018.

~~~
kolpa
How do you survive for 40 days with 0 food, and 7 days with 0 water?

~~~
evgen
Do you know many dead people who suffer from type 2 diabetes? Didn’t think
so... :)

