Your Intrepid Pharmacist knows that unless one has been living under a rock the last decade you are aware of the crisis of obesity and diabetes that has exploded as one giant healthcare dollar consuming plague in the United States. Anyone who has done even the most cursory reading on these two subjects know that the problem continues to mount and that a plethora of new drugs have come into being to help combat and manage obesity and diabetes.
What all the press coverage has failed to mention is that most of this plague is completely avoidable and that the American health system has completely mishandled it. And no one makes this more clear and resonant than Jeff O’Connell does in his book Sugar Nation. Here in Tennessee the obesity and diabetes rates place the state among the worst in the nation at 46 of 50 states in 2011 for diabetes and for obesity in 2010 the state ranked 49 of 50 among adults and 44 of 50 among children. Those who wish to see a by county mortality (death) rate by county for diabetes go here. O’Connell, who visits the south for part of his book, makes it clear the diabetes problem is one where the health care profession itself is guilty of mishandling, misinformation and misdirection.
Diabetes and obesity are commonly linked (metabolic syndrome largely owes existence to this notion) and O’Connell is quick to point out these twin problems is diet and lifestyle in origin. He cites a large, but well buried study from 2003 that found diet and exercise modifications had a far greater impact on diabetes than the first line diabetes drug metformin did. He then goes on to show how the medical community is largely ill equipped to provide competent advice and direction on how to manage these disease states. In one glaring instance of many, the then head (2007) of the American Academy of Family Physicians, a doctor from Selmer, Tennessee, was giving patients totally wrong direction on how to manage their diabetes and was proceeding to make it worse by increasing the amount of carbohydrates they were consuming.
On top of that O’Connell exposes that major diabetes agencies like the American Diabetes Association have huge corporate sponsorships from the likes of Coca-Cola, Pepsico,, Kellogg’s and Mars; all makers of some of the most nutritionally vacuous and/or sugar ridden products on the market. By the book's end one must wonder what the ADA's actual purpose is. Likewise, drug companies are raking in piles of money off of new drug development for a disease state that is largely fixable if—IF—the patient makes the necessary diet and lifestyle modifications.
That “if” is nearly impossible even for the patient who wants to make changes since health care providers are so pressed for time a patient may only see his/her physician for 15 minutes a couple times a year; not nearly enough time to establish and direct the changes that need to be made and provide support for it. Imagine if Alcoholics Anonymous ran on this model of care: very likely no one would ever be able to stop drinking.
When a health care provider does try to give direction, too often the direction is vague or outright wrong since physicians and pharmacists are trained in medical schools on drug treatments and not nutrition and exercise. O’Connell rightly points out that personal trainers at a gym know more than most health care professionals when it comes to diet and exercise since they actually walk the talk themselves.
Swirling at the center of this health care disaster is sugar itself (hence the book’s title); a substance that comes from carbohydrate breakdown in the body and whose refined form has become so pervasive it can be found in virtually everything we consume from preservative use in prepackaged “deli” meat to the 13 teaspoons worth found in soda.
Your Intrepid Pharmacist could go on citing more examples from this excellent book, but he hopes you get the idea. Sugar Nation is very approachable for the non-medically trained person and by the last page you should see just how dire the situation has become with corporate profits (both junk food and drug making on one side) and lack of education among medical professionals on how to treat diabetes (or obesity) driving an uneducated public into the passive action of expecting all one needs is another pill. Plus, taking a drug is far easier than actually having to take responsibility for one’s diet and exercise, so this “solution” is an easy sell. A solution that O’Connell demonstrates is tantamount to placing a band-aid over a tumor. Plus, as your Intrepid Pharmacist always tells his own diabetic patients: “you can out eat any drug I can give you.”
The plight of obese and diabetes ridden states like Tennessee is clear and O’Connell shows the solution is within our grasp… But as a patient once put it to your Intrepid Pharmacist, “You have to die of something, right?” In principle this is true but your Intrepid Pharmacist says that it should not be from something that is preventable in the first place.