Embracing a Future With No Cure for Diabetes: an American Editorial

   

  

     I came to terms with this a long time ago. There is never going to be a cure for Diabetes. It's cool. I understand. I have accepted it.

     Why would anyone who could potentially cure it want to cure it? It is a disease that has it's own section of the job market and a significant piece of the overall drug pie chart. So, what is there to gain with its eradication, financially speaking? Imagine all of the hard working folks who would be out of jobs should diabetes go the way of smallpox. From diabetes educators and specialists, to insulin pump, test strip, meter, and insulin manufacturers, to dietetic cookbook writers, and diabetic neuropathy sock makers, and everyone in the chain of commerce. Glucagon and glucose tabs would be useless and unnecessary to manufacture. The industry would disappear and the displaced workforce would struggle to adapt. I would kinda feel horrible if millions of people were suddenly unemployed because something that has become so simple to control (relatively speaking) was cured.

     The truth is, before we could ever expect a cure, we need to look at diabetes as a business model. To be competitive and prosperous, a business needs to meet a supply and demand ratio with disposable products in order to generate a consistent, reliable income. The products need to draw forever consumers via absolute reliance, addiction, or repeat/replacement purchasing. Companies know this. It is business 101. The huge test strip to meter cost disparity is not because test strips are costly to produce. A meter only costs about 20 bucks, but the test strips- the thing used once and throw away- are 6000 times as expensive annually. The pattern exists in many other dynamics beyond diabetes. Video games cost much more than the console. Older cars used to last much longer and without as many repairs or breakdowns as new ones. Laptops and computers "are designed" to fail and be replaced after a few years. Couldn't all of these things be made better, stronger, more reliable? Have we lost that ability as technology has increased? My understanding is that a throw-away culture is much more profitable.

source: TXCOWBOYDANCER, from May 2015 Consumer Reports     

     Perhaps I've strayed too much... Getting back to diabetes, the ultimate goal for a diabetic related business is to manufacture products and treatments that extend customer lives and make diabetes easier to cope with. The history of diabetes products have followed this trend. At one time, needles were connected to glass reservoirs that needed boiling for sterilization and reuse. This was a difficult, time consuming process, not to mention, sustainable. Syringes then became disposable. The needles shrunk, were easier and less painful to use. Later on, insulin pumps made control even better. The original insertion sites were bigger, metal and restrictive. Over time, they became more comfortable, plastic, easier to use, and smaller. At the same time, fast acting insulin came along to treat high sugars better and more accurately. Now CGMs help regulate sugars better. We're getting closer to reliable technology which will create a perfect functioning external pancreas. Each step has brought diabetics closer to mimicking what non-diabetic bodies do. Each technological advance cures a little hassle of treating diabetes, but the more manageable diabetes becomes, the more we distance ourselves from a cure. Now, I am not trying to vilify the tremendous breakthroughs in diabetic care; I do live a much healthier life. I also accept this situation, and understand that there will never be a cure. 

     And why should there be? What is the actual incentive to cure diabetes? Maybe a few scientists are inspired by a loved one with diabetes, or themselves even, and want to be the one to find a cure. Who funds the research? What venture capitalist or drug company would want to put money into getting rid of such a money maker? How hard would other companies try to squelch the cure, or make it an impossibility to attain? And there lies the inherent problem: curing a lucrative disease does not work in a marketplace (or country) built on capitalism.

infographic from asweetlife.org

     Research is supported by grants or companies that profit from research. But there is no motivation for a company to invest in a cure of a disease that is easily treatable, and more importantly, self-sustaining and profitable. The money that could be devoted to "cure" research is diverted to develop technological breakthroughs. If any new breakthrough is discovered, the first reaction is not how to release it to help human kind, but how can it be made cheaper and more profitable. So when .orgs and foundations claim they want to find a cure, I suspect their message is false. Just look back at the evolution of insulin delivery and treatment. If the true goal of any fundraising company was to find a cure, then more money should have been granted in that direction over the past 75 years. It has not, and I'm OK with that.

     Sure, there have been cures produced for life threatening diseases in the past. But the diseases were cured in a different era. It was a time before technology reached today's standards, where we can now ask "can it be treated rather than be cured?" It goes back to the idea that we used to to manufacture products that lasted a long time. Thanks to increased profit margins, and an unhealthy obsession with wealth and capitalism, we now make stuff that breaks quickly and is easy to replace. We live in an era of quantity, not quality. 

     And I haven't even touched on the monster that is health insurance...