One of my earliest memories is of myself pushing a chair around my grandmother’s kitchen to make a sandwich. I know that I’m probably four years old from the tile on my grandma’s floor and the chair I’m standing on. The loaf of bread is on top of the fridge, and the mustard is high in the cabinet. Once I’ve gathered all the ingredients, I’d make a sandwich with meat, cheese, mustard, mayo, and a napkin. This isn’t about my earliest memories. This is about food. The kinds of food that cause diabetes and the consequences of where you get food. Diabetes is a big problem in the US. As the government goes through its unrelenting cycles of waxing and waning to decide if the health of individuals is worth cutting the profits of a large corporation after large corporation.
In August, @POTUS met with Gail who has Type I diabetes.
I followed up with Gail, to check in. Under our Build Back Better Act, the cost of insulin will be capped at $35 a month for millions of Americans. pic.twitter.com/yLeeCvxXsO
— Vice President Kamala Harris (@VP) December 6, 2021
What is Diabetes?
Diabetes mellitus is a disease where the body has trouble responding to blood glucose and insulin. Type 1 Diabetes usually appears when the patient is still a minor and the pancreas does not produce enough insulin because of the loss of beta cells in the pancreas. Type 2 Diabetes is characterized by the body not responding to insulin correctly and is insulin resistant. Other symptoms include frequent urination, chronic fatigue, weight loss, and high amounts of thirst/ hunger for all types of diabetes. Diabetes was first described by Aretaeus of Cappadocia as a “‘wasting illness’ where the patient’s limbs turn to urine.” Jumping to the postmodern times and diabetes is very common, with nearly half a billion people affected by the illness worldwide. It is hard to ignore that the price of insulin is high enough to put into question the ethics behind a deadly business model.
Inventing Personal Responsibility
Although many people are affected by a life-threatening disease, there’s minimal outcry for a cure. Diabetes is a manageable illness when a patient has the right tools. The number one treatment for diabetes is diet and exercise. This creates the illusion that individuals with diabetes do not prioritize their health and have diabetes because they are irresponsible. This is especially true for those who are type two diabetic because type two develops gradually with “lifestyle choices.” Programs like the Biggest Loser,
and even Michelle Obama’s Let’s Move campaign reinforces the idea of personal responsibility for physical health. Individuals simply need to choose healthy choices and not unhealthy choices to keep their diabetes under control.
Sugar, Meat, and High Processed Foods
In an article by the New York Times, they list the most addictive foods, and the list is mostly sugar or meat.
They list the following:
- ice cream
- french fries
- soda (not diet)
- fried chicken
- rolls (plain)
- popcorn (buttered)
- breakfast cereal
- gummy candy
Food high in fat, sugar, and highly processed foods have the most addictive traits. According to the article, highly processed food is designed to be extremely palatable, and healthy food can only compete marginally because processed food interacts with a different portion of the brain. This food triggers extreme rewards in the brain. We know from research that meat is more harmful to the health of diabetics because it clogs the arteries that then build up with what can be thought of as a backlog of sugar that the pancreas simply cannot keep up with the high production needs of insulin.
These types of highly processed food frequent the underserved communities with less healthy food options.
For instance, in California, West LA has half the population of South LA and twice the amount of grocery stores. South La is known as a food desert because there are fewer healthy options in the community. Convenience stores, Fast Food Restaurants, and Gas Stations feed this community. A grocery store’s profit is only pennies on the dollar, so businesses must be incentivized to invest in communities with more risk. Locations with no other investors, high business insurance rates, and more possibility of theft become rife with Diabetes, high blood pressure, high cholesterol, and obesity. A grocery store owner will rationally flock to a location without the additional challenge, a city like West LA.
I want to clarify that grocery store owners are practicing smart business by avoiding neighborhoods where they would have the most loss. However, crime is not a problem in society but a reaction to a problem in society. People who are well-fed and don’t have food insecurity don’t steal food, baby formula, etc.
Fiscal Determinants of Health
Diabetes costs individuals an estimated additional 20,000 dollars a year. The median household income can be as low as 50,000 a year in food deserts. This places a huge financial burden on individuals who need to pay for insulin, doctor co-pays, and prescription refills. It would be easier to cope with diabetes when you have the additional resources. But this forces people to choose between paying for bills and paying for insulin which is integral to their health. The public health care system is bare-bones and shifts the burden back onto patients when it comes to caring. Individuals who work full time or often full time and half have to carve out time for appointments while possibly having families to care for and monitoring their blood sugar 24 hours a day. Then when it’s the end of the night, and it is time to eat something, driving the other side of town to the grocery store to then cook a balanced meal that’ll take another hour before everyone eat, Taco Bell is the more viable option even if it’s not the ideal option.
These challenges gridlock individuals with diabetes into a position where the healthy choice is not much of choice.
Lack of access to Health insurance stacked on food deserts constantly feeds back into each other until the damage is irreversible for a completely manageable illness with modern science. This doesn’t only affect individuals with diabetes. People with high cholesterol and blood pressure are caught in the same system, with people telling them that if they merely keep up a healthy lifestyle, they could get their illnesses under control. A healthy lifestyle comes at a huge effort for people already putting a huge effort into trying to make a living wage. It’ll be no surprise that those struggling with diabetes come from black and brown communities.
Big Business Interest In Diabetes
Obesity is one of the biggest factors in the development of diabetes, followed by aging and an unhealthy lifestyle. As the number of diabetic individuals grows each year. The size of potential consumers does as well. Diabetes is a global epidemic, with China leading the numbers in death, with 20% of the deaths from diabetes coming from its population. This creates a higher demand for glucose monitoring devices and high-end insulin pumps. The diabetic market size is 25.3 billion dollars as of 2020, and it is expected to grow at a rate of 6.6% every year. Big players like Apple and Google are in an arms race to disrupt the health care industry. Diabetes is a growing and fertile market opportunity. There is no better way to get people to empty their pockets than to remind them their life depends on a device or medication. Abbotts Freestyle Libre presents an affordable glucose monitor with a more straightforward design. The second glucose monitor is the Dexacom is super high-end with the ability to connect to smartphones and Apple watches.
Abbotts FreeStyle Libre and Dexacom have over one hundred patents combined.
Here’s a quick lesson on Patents:
With that in mind. The legacy of bad actors like Elizabeth Holmes (former CEO of Theranos, a blood-testing company that was a complete fraud) and Martin Shkreli (a Medical Hedge fund manager who raised the price of Daraprim from $13.50 a tablet to $750) puts consumers in a complicated place of trusting medical companies. Because even when they knowingly act in the interest of profit to the detriment of people, our government only charges them with crimes related to the finances of it all.
The overall negligence of diabetic patients is reinforced by systems designed to protect profit and corporate interest over humanity. But furthermore, it’s…
…that people continue the myth that people who have diabetes are at fault. This is a series of negligence from multiple entities. From the FDA, limited access to health care, limited access to healthy food, working two and three jobs to get by, and then PAY 200 dollars for Humalog. Diabetic individuals are alone when they try to navigate their illness to make a better life for themselves in the face of many systemic challenges. Diabetes can be a very aggressive illness when you don’t have resources. Often leading individuals to be blind, with gastroparesis, have their extremities amputated, have heart disease, and ultimately die prematurely. By blaming diabetic people for their illness, you help these faceless institutions deflect the blame for harming countless people, NOT EXCLUDING YOURSELF. While you have the chance invest in your health because nothing in the American health care system exists to help you. Start putting your money where your mouth is because it cost so much more to be diabetic.