Diabetes: Better than hedge funds

Diabetes is where the action is.

While, for virtually all of history, type 2 diabetes was an uncommon condition of adults, the disease has spread so much to all levels of American society that even kids are now developing the adult form. Researchers from the Center for Disease Control and Prevention predict that, by 2050, one in three adults will be diabetic.

The diabetes market is booming, handily surpassing growth of the oil industry, the housing market, even technology. It makes Bernie Madoff’s billions look like small potatoes. In health, few markets are growing as fast as diabetes—-not osteoporosis, not heart disease, not cancer.

Americans are getting fat from carbohydrate consumption, becoming diabetic along with it. While kids hanging around the convenience store gulp down 26 teaspoons of sugar in 32-ounce sodas and 56-grams-of-sugar in 16-ounce frozen ices, health-minded adults are more likely eating two slices of 6-teaspoons sugar-equivalent “healthy whole grain” bread, wondering why last year’s jeans are too tight.

The U.S. is not the only nation affected. Globally, 2.8% of the world’s population are diabetic, a number expected to double over the next 20 years.

Pharmaceutical companies boast double-digit growth for diabetes drugs, growth rates that keep profit-hungry investors happy. Merck’s Januvia, for instance, introduced in 2006, recently catalogued 30% growth in sales, with annual sales approaching $1 billion. Recently FDA-approved Victoza, requiring once-a-day injection, is expected to reap $4 billion in sales per year for manufacturer Novo Nordisk. Such numbers can only warm a drug company CEO’s heart.

Most diabetics don’t just take one medication, but several. A typical regimen for an adult diabetic after a couple of years of treatment and following the dietary advice of the American Diabetes Association includes metformin, Januvia, and Actos, a triple-drug treatment that costs around $420 per month. Two forms of insulin (slow- and fast-acting), along with two or three oral medications, is not at all uncommon.

“Collateral” revenues from the other health conditions that develop from a diet rich in “healthy whole grains,” such as drugs for hypertension, drugs to slow the progression of kidney disease in diabetes, drugs for “high cholesterol,” and drugs for high triglycerides, and you have a pharmaceutical drug bonanza. You, too, would throw all-expenses-paid, fly-the-entire-sales-force-to-the-Caribbean sales meetings.

The global diabetes market has already topped $25 billion and is growing at double-digit rates. Forget the Internet, gold stocks, or solar energy—-diabetes is where the money is. This fact has not been lost on the very market-savvy pharmaceutical industry. As with any successful business, they have devoted substantial resources to develop and grow this booming business.

Comments (23) -

  • Kurt

    3/7/2011 5:19:04 PM |

    Since I changed my diet to lower my cholesterol, my fasting blood sugar went from 98 to 82.

  • praguestepchild

    3/7/2011 5:51:32 PM |

    I'm not sure the pharmaceutical industry is any more market-savvy than any other industry, less I would say. They spend quite a bit of their time and money influencing politicians and doctors in an extremely distorted feedback loop of regulation, regulatory capture, and lots of sleazy baksheesh.

    I'd prefer to invest my money in a company that really is market-savvy in an unfettered market. Like Apple.

  • Patty

    3/7/2011 6:10:53 PM |

    I'm floored.  I had no idea that diabetics took so much medicine and spend so much money on it.

  • Might-o'chondri-AL

    3/7/2011 7:54:30 PM |

    285 million diabetics worldwide is a lot. There are also 100 strains of entero-virus ( a sub-group of picorna-viruses).

    Type 1 diabetic children show 60%with entero-virus in their pancreas beta cells. Type 1 is usually said to be an auto-immune destruction of beta cells.

    Type 2 diabetic adults show 40% entero-virus infection in beta cells; whereas, the general non-diabetic rate is 13% infected.

    4 genetic variants of the gene IFIA-1 enzyme inducing an immune response were identified. It affects how the immune reaction to picona-virus RNA inside a cell cytoplasm plays out; some get over-reaction of interferon Beta.

    Another genetic factor recently discussed involves the human inability to make the sialic acid NeuSGc. Gene CMAH enzymes aren't able to produce this sialic acid on the outside of our cells; it limits human, as opposed to other mammals, control of blood sugar.

    Some individual genetics have both less number of pancreatic beta cell and diminished size of the islets. They don't put out enough insulin to meet the demand.

    Maybe we'll see a vaccination program for specific non-polio entero-virus; it's worthwhile, even if not relevant to all diabetes. If I could patent reversal of fatty liver to overcome genetic pancreatic insufficiency riches would be mine.

  • Henry Lahore

    3/8/2011 1:47:18 AM |

    Vitamin D appears to both prevent and treat diabetes.
    http://www.vitamindwiki.com/tiki-index.php?page_id=339

  • Paul

    3/8/2011 3:54:25 AM |

    You know when an industry is growing by leaps and bounds by the amount of TV ad space they buy... it's startling how many commercials there are right now targeting the diabetic consumer.

    The one advertisement that I find most disturbing though is the one for Onglyza.  The ad says, "you exercise and eat right but your blood sugar may still be high, so you need extra help."

    This specific medication is designed to prevent after meal blood sugar spikes.  But, right there in the middle of the ad it shows a man (with a large wheat belly) eating a sandwich with what looks like two slices of "healthy whole wheat" bread.  This explains a lot (to me) when it comes to what kind of message this company is trying to send.

    It's a kin to producing an advertisement for Nicorette gum while showing young, attractive teens enjoying themselves smoking cigarettes.

  • Dr. William Davis

    3/8/2011 4:05:51 AM |

    Hi, Prague--

    Please don't mistake my tongue-in-cheek comments for investment advice.

    In fact, outsized profits or no, I wouldn't think of investing in what I feel is an industry governed by greed and the pursuit of perverse profits.

    Hi, Paul--

    Yes. It seems to say, "It's not your fault. We can help. Go ahead and enjoy your sub sandwich."

    50 years from now, they will look back and laugh at our dietary disasters, wondering why we never got it right.

  • Daniel A. Clinton, RN, BSN

    3/8/2011 4:09:47 AM |

    I suspect Vitamin D's role in protecting against diabetes is multifactorial. I suspect that viruses that may infect the Vitamin D deficient bounce off those with optimal Vitamin D. I suspect Vitamin D also plays a direct role in the beta cells of the pancreas. I don't know how restorative Vitamin D is, but I strongly believe Vitamin D has huge preventative effects, which is part of why we have such absurd Vitamin D recommendations.

  • Anonymous

    3/8/2011 6:24:18 AM |

    brilliant viewpoint doctor. lots of love.. Smile)

  • Anonymous

    3/8/2011 6:35:51 AM |

    The whole diabetic thing is astonishing to me. It's an epidemic and will cost us gazillions in health care money, and the pain and misery is going to be horrible. I have been a RN for 35 years and otherwise intelligent people just look at you blankly when you suggest changing their diet or even just walking. They say, "oh, my doctor is happy with my A1C of 7" or "he added another medication and now things are fine." Their lights are on but no one is home!!!

  • Anonymous

    3/8/2011 8:43:57 AM |

    I found an interesting page regarding Vitamin D and diabetes (among other things):

    http://www.vitamindwiki.com/tiki-index.php?page_id=339

    The conclusions from the available research are as follows:

    - It appears that > 2000IU VitD3 will prevent diabetes
    - It appears that > 4000IE VitD3 will treat (but not cure) diabetes
    - It appears that calcium and magnesium and needed both for prevention and treatment.

    Pretty interesting summary.

  • Kris @ Health Blog

    3/8/2011 8:50:51 AM |

    Those are really terrible news, I wonder if all those profits have something to do with how slow governments seem to be in waking up to the fact of how easily those diseases are preventable.

    It's incredible that all of this is so easily fixed with a simple change in lifestyle, yet nothing seems to happen.

    -Kris

  • Anonymous

    3/8/2011 8:59:44 AM |

    From an article on the Physorg.com website with the title: Researchers at the University of Saskatchewan have discovered, after a two-year investigation, that diets high in carbohydrates are a probable mechanism for the skyrocketing rates of Type 2 diabetes

    "The work by Kaushik Desai and Lily Wu, professors in the U of S College of Medicine’s Department of Pharmacology, focused on methylglyoacal (MG), which is produced naturally as the body metabolizes glucose consumed in carbohydrates.

    They found that high levels of MG produce all the features of Type 2 diabetes, including damage to insulin producing cells in the pancreas, insulin resistance and impairment of body tissue to use glucose properly. Their finding are set to be published in the American Diabetes Association journal Diabetes in March."

    And I thought the ADA wouldn't allow such findings to be published because they go against the ADA's "dietary" advice.

  • praguestepchild

    3/8/2011 12:16:08 PM |

    Dr Davis wrote: "Please don't mistake my tongue-in-cheek comments for investment advice.

    In fact, outsized profits or no, I wouldn't think of investing in what I feel is an industry governed by greed and the pursuit of perverse profits."

    I understood the irony. But the perverse profits are, IMO, a result of regulatory capture, and many other market distorting incentives like the unequivocal government acceptance of the diet-heart hypothesis.

    As far as greed goes, if you don't like "greed" perhaps you shouldn't invest in anything but simply donate it all to charity ;)

  • Stargazey

    3/8/2011 1:34:00 PM |

    This discussion is all very idealistic, but don't forget the fact that our government is totally and completely in the pockets of Big Food.

    Think of all the political contributions made by ConAgra, General Mills and Cargill. If the government started preaching against sugar, wheat and industrial oils, there would be hell to pay. It's much easier for our politicians to nurture an antidiabetes pharmaceutical industry than it is for them to go up against the massive clout of Big Food.

  • JEAN

    3/8/2011 4:08:40 PM |

    That's why, Stargazey, voting with your pocketbook is the only way, and blogs like this. Every time I come here, and to other similar sites, there's usually one poster who's so thankful they've found this information. And Paleo-Primal diets are now on the evening news, five years ago, that life style was considered to be fringe, nutters only accepted.
    So, one person at a time, but you've got to start somewhere.

  • Margaret

    3/8/2011 11:08:54 PM |

    I don't go for all these conspiracy theories.  I think it is just terribly difficult to get people to change their foodways and get exercise.

  • fatfree

    3/9/2011 4:18:04 AM |

    And fingerstick tests are also part of industry. Hm...

  • Might-o'chondri-AL

    3/9/2011 5:55:49 PM |

    http://www.pnas.org/content/early/2011/03/03/1019007108.full.pdf.+html.

    In utero epigenetics (& age) influence diabetes....
    ? Are you what your mother ate as well as what you eat ?

  • Might-o'chondri-AL

    3/9/2011 5:59:27 PM |

    Link got chopped; so, after second ".../03/" put this:

    1019007108.full.pdf.+html.

  • Might-o'chondri-AL

    3/10/2011 3:09:32 AM |

    http://www.ajcn.org/content/71/5/13445/T1.expansion.html

    Control may very well be via Doc's method. Diabetes progression may be individual.

    Epigenetic vulnerabilites chart
    includes glucose/insulin, insulin resistance, glycolysis in exercise, etc. Free full article link chart from is at right.

  • Might-o'chondri-AL

    3/10/2011 3:11:45 AM |

    Again chopped link; end reads "... T1.expansion.html"

  • body lift

    3/22/2011 11:33:21 AM |

    Really nice post. Thanks for share it.

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