
40M people with diabetes will be left without insulin by 2030, study predicts - ytNumbers
https://www.ksl.com/article/46431985/40m-people-with-diabetes-will-be-left-without-insulin-by-2030-study-predicts
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jcims
No explanation as to the cause of the shortcoming. Do drug companies just hate
money?

Madehow has a decent article on the history of insulin synthesis [1]. I don’t
see any natural bottlenecks that would interfere with scaling the process.

1\.
[http://www.madehow.com/Volume-7/Insulin.html](http://www.madehow.com/Volume-7/Insulin.html)

~~~
HarryHirsch
Profits for generics are too low and there are no new market participants
because outlays for initial investment and conformance testing is too high.
Generics manufacturing is a strange beast, there are surprisingly few players
involved, there is very little overcapacity, and that's not a good situation.
When Hurricane Maria took out pharmaceutical plants in Puerto Rico there were
severe drug shortages that were not easily fixed.

~~~
gumby
This is good fodder for a case that a public utility should produce these
drugs. Of course that would freak various interests out so won't happen, at
least in the US or EU.

A hybrid approach in the US has been fairly useful for orphan indications and,
somewhat differently for vaccines, but of course jerks found ways to exploit
that too. Still it points to a possibility.

But I favor a single utility making some small-molecule and biologic
underserved drugs because of the economy of scale it could bring. A small NIH
facility in some otherwise underserved part of the country could make a big
difference at a relatively low cost.

~~~
rayiner
If this was a viable model, I strongly suspect you would've already seen this
happen in one of the many countries with socialized health care. I suspect
you're assessment of the approach as "relatively low cost" is faulty. Biologic
production is extremely difficult and expensive.

~~~
HarryHirsch
_Biologic production is extremely difficult and expensive_

It's not that bad. Brewers developed the knowledge how to work with
microorganisms centuries ago. Most antibiotics are biologics, and they are
dirt-cheap. Insulin isn't monoclonal antibodies, it's grown in bacteria, in
the simplest expression system, and how to isolate it from the fermentation
batch is well-understood and involves no problematic steps.

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open-source-ux
Type 2 diabetes can be reversed through diet. The evidence comes from medical
practitioners and scientists, not from quacks making outlandish claims
(although they exist too).

Some links:

 _The Diabetes Code by Jason Fung_ : This is a best-selling book by a Canadian
Nephrologist (care and treatment of kidney disease) that explains type 2
diabetes in detail and recommends diabetics switch to a low-carb diet.

 _Counterweight Plus low-calorie diet plan_ : This diet was run as part of a
scientific trial and showed promising results for obese patients with type 2
diabetes. Nearly half of the 300 patients in the trial reversed their
diabetes. Note: the diet was run under the supervision of medical
professionals and is not suitable for everyone:
[https://www.nhs.uk/news/diabetes/radical-low-calorie-diet-
ma...](https://www.nhs.uk/news/diabetes/radical-low-calorie-diet-may-help-
reverse-type-2-diabetes/)

 _The Truth about Carbs_ : this is a BBC documentary from earlier this year
which is unfortunately no longer available to watch on the BBC website. It
featured NHS doctors who ran a two-week low-carb diet plan with type 2
diabetic patients. All patients reported improvements to their health, but the
most impressive result was a patient with type 2 diabetes for 17 years who was
now in part-remission.

Here is a thorough write-up of the programme: [https://www.diabetes.co.uk/in-
depth/truth-about-carbs-bbc-1-...](https://www.diabetes.co.uk/in-depth/truth-
about-carbs-bbc-1-review/)

A clip from the programme:
[https://www.youtube.com/watch?v=eKQWFJmCWZE](https://www.youtube.com/watch?v=eKQWFJmCWZE)

10 things you may not know about carbs:
[http://www.bbc.co.uk/programmes/articles/4DfZMpv7BYJ3kGXdHxd...](http://www.bbc.co.uk/programmes/articles/4DfZMpv7BYJ3kGXdHxdxkKp/10-things-
you-may-not-know-about-carbs)

Just to re-iterate, the examples above all refer to types 2 diabetes, not type
1 diabetes.

~~~
EdgarVerona
Something important that I think is worth noting is that you can reverse the
symptoms of T2 Diabetes, but it does require a lifelong change of lifestyle.
If you go back to your old lifestyle, those symptoms are just going to come
right back. I know to some it may be obvious, but I think it's worth stressing
this. When people say "reverse," they're talking "in remission." The symptoms
are waiting to return if you start fucking up again. That being said, it is a
much better approach than the alternatives.

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giardini
Wonder why they picked 2030. I _might_ have read a 3-year forecast since they
are sometimes correct. But any forecast involving social processes that is
beyond 5 years is almost always wrong.

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encoderer
Virta Health is a sf startup with meaningful results reversing T2 diabetes. If
you’re interested in this topic they are a compelling counterpoint to this
study.

~~~
wild_preference
Type 2 diabetes can be reversed. Many people aren't seriously suggested this
option by their medical professional or are unwilling to change their
lifestyle.

I don't think it's a counterpoint to the study, but rather to the ways the
data will drive policy changes.

It's taboo to take the obesity problem seriously.
[https://en.wikipedia.org/wiki/Fat_acceptance_movement](https://en.wikipedia.org/wiki/Fat_acceptance_movement)

~~~
noarchy
>It's taboo to take the obesity problem seriously.
[https://en.wikipedia.org/wiki/Fat_acceptance_movement](https://en.wikipedia.org/wiki/Fat_acceptance_movement)

It is phenomenal to see such a movement sprout up, as if a chunk of society
decided to just give up. I couldn't imagine a serious, equivalent movement on
the same scale for alcoholism and cigarette smoking, to cite a few examples.
Yet the abuse of food is going to (or is already) cost us far more.

~~~
ams6110
We pretty much have that with regards to marijuana. I'm not sure why it's
treated so differently from tobacco. In both cases you are inhaling the smoke
from burning leaves.

~~~
opportune
Because you can vaporize it, turn it into oil and again vaporize it, bake it
into food and eat it, etc. too. Even if you do smoke, a regular marijuana
smoker consumes a lot less tar than a regular tobacco smoker since they need
less plant product to get the desired effects. Plus, nicotine promotes cancer
growth (but does not directly cause it) while THC may mildly inhibit cancer
growth

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Flow
All I see from inside the EU is "Forbidden".

~~~
thg
Likewise, but this works:
[https://outline.com/yHC24A](https://outline.com/yHC24A)

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sbenitoj
How about we stop masking the problem of insulin resistance by pumping type 2
diabetics with insulin?

Why don’t we start telling diabetics the truth — your diet is broken and needs
to be fixed; avoid most carbs, do strength training.

We don’t need more insulin to shove the massive onslaught of blood sugar from
your crappy diet into your cells (which are telling you they’ve had enough,
AKA insulin resistance), we need more honesty.

The healthcare industry is morally and intellectually bankrupt. All the honest
people who got into it trying to make a real difference don’t stand a chance,
the truth doesn’t survive for an instant in this corrupt industry more focused
on how much they can get out of insurance companies than treating patients.

~~~
hannasm
Diabetes is an incredibly scary disease and we need more focus on the
underlying causes and permanent solutions instead of pumping all this money
and effort into stop gap measures that perpetuate the problem.

~~~
InclinedPlane
By "perpetuate the problem" do you mean "keep people alive"? Because that is
incredibly heartless.

