Are you one of the 29.7 million Americans diagnosed with diabetes? Perhaps you are one of the 8.7 million Americans with undiagnosed diabetes? These statistics are probably underestimates since they were obtained in 2021 by the American Diabetes Association.

The truth is America is getting fatter and obesity often leads to diabetes. Recent estimates place 42% of Americans in the obese category. You may have noticed that advertisers for diabetes drugs now use obese actors and actresses to peddle their drugs. It seems they want to get the attention of the obese population since that’s the reality of many, though not all, diabetics.

Not surprisingly then, the prevalence of diabetes is increasing. The prevalence of diabetes in America grew from 6.3% in 2004 to 8.3% in 2021 according to the CDC. While obesity is a major risk factor for developing diabetes, family history, age, and race are also important risk factors. These statistics make it likely that one in 10 Americans has diabetes. The World Health Organization lists diabetes as the ninth leading cause of death worldwide.

What is the state of diabetes treatment today?

It has been more than 100 years since the miraculous discovery of insulin to treat diabetes. A lot of progress has been made since then, but there is still much more progress to be made. If you’re a diabetic, or know someone in your family who is, you’ll probably be interested in a new book called Rethinking Diabetes by Gary Taubes. I have not read the book, but I have read a review of the book published in The Wall Street Journal by James S. Hirsch.

Mr. Hirsch, a diabetic himself who has also written books about diabetes, has a unique perspective for reviewing this new book. He says if any disease needs to be rethought, it is surely diabetes, and that is the premise of Gary Taubes’s latest book. A veteran science journalist who has now written five books on the relationship between diet and chronic disease, Mr. Taubes is not interested in the many other factors that undermine diabetic health, including access to care and the affordability of therapies. Instead, he offers a unified theory on why patient outcomes are lagging. The key is food, specifically our overreliance on carbohydrates.

Mr. Hirsch says, “Mr. Taubes believes that diabetes is a cautionary tale for “the medicalization of modern life,” which unduly emphasizes pharmacology over diet and nutrition. We’d be much healthier, he argues, if we ate better and took fewer drugs. Whatever the practical limits of that goal—and I have my doubts—Mr. Taubes’s message is important and should be heard.”

Hirsch goes on to tell us Taubes makes a convincing case that dietary fat has been given a bad rap since even before the insulin era began in 1921. Dr. Elliott Joslin, America’s leading diabetologist in the first half of the 20^th century, was among those who believe that dietary fat either caused diabetes or made its complications worse. He believed that once insulin was discovered, its goal was to allow patients to increase their consumption of carbohydrates – which include such staples as bread, potatoes, and fruit – without sugar appearing in the urine.

The “demonization” of fat, Mr. Taubes writes, would only intensify in the decades to come as it was linked to heart disease, leading the ADA and other health organizations to prescribe diabetic diets high in carbohydrates and low in fat.  But this approach has been discredited recently with respect to heart disease. The American Heart Association no longer recommends the low-fat diet as a solution to heart disease.

The problem is that carbohydrates increase your blood sugar, and elevated blood sugar—hyperglycemia—is exactly what people with diabetes are trying to avoid. The latest tactic now takes the opposite approach – low carbohydrates. This approach is advocated by Dr. Richard Bernstein, an engineer-turned-doctor who also has Type I diabetes. In the 1970s, he became the first person to use a home glucose meter; looking at his data, he realized that a low-carb diet minimized his glycemic swings. For the past 40 years, in his books, academic papers and other advocacy, he has been the leading low-carb evangelist for people with diabetes.

Mr. Taubes’s larger point is that we have allowed pharmacological miracles in the treatment of diabetes, insulin being one of them, to supplant food and nutrition as the foundation of good health. He concurs with Dr. Arnoldo Cantani, a 19th-century Italian physician, who said that the remedy for diabetes “is not in the drugstore but in the kitchen.”

Though I am not a diabetic, I certainly concur with those who advocate diet, exercise, and weight control over a pharmaceutical panacea that seems to gloss over these fundamentally important tenants of good health. America needs to lose more weight, not take more drugs.

There were many tragedies associated with the Covid pandemic of 2020. Millions died worldwide and nearly a million Americans were included in that estimate. But perhaps the greatest tragedy of all was the loss of confidence in our public health officials.

Dr. Scott Atlas says this loss of confidence extends to science itself, and that is the public health emergency of today. Dr. Atlas is a professor of medicine at Stanford University and was briefly associated with the Trump Covid response team near the end of his presidency.

Dr. Atlas, writing for independent.org, says, “The loss of trust is part of the disgraceful legacy of those who held power during the pandemic. Two presidents and dozens of governors hid behind public health bureaucrats Anthony Fauci, Deborah Birx, Robert Redfield, and Rochelle Walensky. They ignored Henderson’s classic review 15 years earlier showing lockdowns were both ineffective and extremely harmful. They rejected the alternative, targeted protection,recommended as early as March 2020 by Ioannidis, Katz, and Atlas. Beyond a reckless disregard for foreseeable destruction from their policies, America’s leaders imposed sinful harms and long-lasting damage on our children, the totality of which may not be realized for decades. Mandatory school closings, forced isolation of teens and college students, and required injections of healthy children with experimental drugs attempting to shield adults will be a permanent black mark on America. And the truth cannot be denied—the Birx-Fauci lockdowns failed to stop the death and the spread of infection (see Bjornskov, Bendavid, Agarwal, Herby, and Kerpen) and inflicted tremendous harms, shifting the pandemic burden to low-income families to spare the affluent.

What can be done about this?

Dr. Atlas says America’s next president needs to lead with strong reforms, because the Birx-Fauci stain on public health and science jeopardizes the credibility of all future health guidance. He does offer some suggested executive orders to fix the problem:

• Clearly define by law “public health emergency” with strict time limits (e.g. two weeks), requiring legislation to extend. This is to protect our human rights, which were violated during the pandemic. Guarantees of the most fundamental freedoms upon which this country was founded – speech, religion, assembly – were suddenly reversed, without limit, by lockdowns justified under the guise of “the science” and “safety.”
• Add term limits (e.g. six years) to all health agency positions, including top and mid-level posts, after first cleaning house of all heads of CDC, NIH, and FDA. For instance, Anthony Fauci worked as a bureaucrat for 38 years. Such longevity accrues power and seems to inhibit dissenting voices, while setting up unhealthy relationships with outside parties, including the media.
• Forbid all drug royalty-sharing by employees of FDA, NIH, CDC – and forbid related private jobs for five years after government service. OpenThe Books revealed that between 2009 and 2021, approximately 54,000 royalty payments totaling $325.8 million were paid by third party entities to NIH researchers, sources redacted. Dr. Francis Collins, former NIH director, received 21 payments and Dr. Anthony Fauci received 37 payments between 2010 and 2021. This represents a shocking conflict of interest.
• Require full transparency of all FDA, CDC, and NIH discussions with immediate posting to public forums. Statements from all advisors in those meetings, such as the startling October 26, 2021,recommendation of Eric Rubin, M.D., FDA advisor for children’s COVID vaccines, that “we’re never going to learn about how safe this vaccine is [in children] unless we start giving it. That’s just the way it goes,” must be widely visible to the public.

• Restatement with executive order that the CDC and other health agencies are strictly advisory and do not have power to set laws or mandates. Limiting health agency power is a way to begin holding elected officials accountable to the citizens, rather than allowing the pretense of hiding behind those agencies.

• Decentralize today’s cartel of NIH funding that controls all academic science careers and university medical centers.The NIH is the dominant funder of all scientific research, to the tune of $45 billion per year. This may explain the February 202 Lancet publication concocted behind closed doors calling the lab origin of the SARS2 virus a “conspiracy theory” – perhaps to conceal NIH malfeasance overseen by Drs. Collins and Fauci, who sent more than $2 million taxpayer dollars to fund China’s dangerous gain-of-function research to circumvent our country’s restrictions. Instead, disseminating control of NIH funding across regions with block grants to states would reduce this grip on independent voices.
• Immediately halt all binding agreements or pledges to the World Health Organization. The U.S. is the largest funding nation to WHO activities, but the WHO record is abysmal. In addition to supporting China’s stonewalling, Director Tedros backed China’s reckless human rights violations, stating “the Chinese government is to becongratulated for the extraordinary measures it has taken to contain the outbreak,” even as it used pseudoscience to essentially imprison its citizens. WHO disregarded evidence in its guidelines on mitigation, censored its own staff for acknowledging limits of asymptomatic spread, and flipped fundamental definitions like “herd immunity” to influence behavior, rather than to dispassionately inform with data.

That’s a lot to digest, but Dr. Atlas is on point in his understanding of the deficiencies of our current public health system. Too many bureaucrats are looking out for their own interests instead of providing scientific advice to benefit the country. We must ensure that we can trust the scientists in our public-health system or we will repeat the chaos of the last pandemic the next time.

(Author’s note: For more on this subject, I recommend Dr. Atlas’s book,  A Plague Upon Our House.)

Regular readers of this blog know I often criticize ObamaCare, formerly known as The Affordable Care Act of 2010. It was passed without a single Republican vote by the Obama administration and has failed to achieve its promoted goals of lowering the cost of healthcare and providing healthcare coverage for every American.

Democrats counter with their own criticism of Republicans, claiming they have no alternatives to offer. While this is certainly untrue, it is true that Republicans failed to deliver on their promise to abolish ObamaCare and replace it during the first two years of the Trump administration, thanks largely to rebel Republican Senator John McCain of Arizona, who despised President Trump.

But now, the Republican-controlled House of Representatives has passed three new bills to improve healthcare with bipartisan support. It’s up to the Senate now to see these bills become law.

Grace-Marie Turner, writing for Galen.org, gives us the details of these three new bills:

• By a big 320-71 bipartisan vote Monday night, the chamber passed the Lower Cost, More Transparency Act,a major team effort of the three major committees with jurisdiction over health policy issues—Energy and Commerce, Education and Labor, and Ways and Means.
• The House passed in June a companion bill, the CHOICE Arrangements Act, that gives small businesses more options in providing health coverage and gives employees more flexibility in how they spend their health coverage dollars.
• On Tuesday, the House reauthorized opioid treatment and prevention programs through the SUPPORTAct, passed soon after a Senate health committee passed its own version of the measure.

She also notes that all three bills went through the normal legislative process, starting with subcommittee hearings to vet the details of the bills, and not via a huge, clumsy, opaque “omnibus” special bill that no legislator has time to read or consider. The three bills each incorporate numerous targeted bills sponsored by individual members.

She goes on to explain: “These are important milestones toward patient-focused health care.  Dozens of members worked together through the Healthy Futures task forces that began work in 2020 to set out an agenda for health reform and engage members in the details of policymaking.  The overall goal is to give people access to choices of more affordable health coverage and care in a revived market catering to their needs and preferences.”

How do these bills improve healthcare?

• The Lower Cost, More Transparency billrequires hospitals, health insurers, labs, and other providers to make accurate, accessible price information available to patients and consumers.  It addresses the obfuscation of drug prices by pharmacy benefit managers that can inflate prices and co-payments for patients, and would lower out-of-pocket costs for seniors who receive outpatient medications in a hospital-owned setting.
• The CHOICE Act (“Custom Health Option and Individual Care Expense Arrangement Act” or the “CHOICE Arrangement Act”) recognizes the difficulties small businesses have in providing health coverage to their workers and gives new options to businesses in vulnerable small group markets. The bill includes the Self-Insurance Protection Act and would codify access to more and more affordable coverage options through Association Health Plans.It also would codify and improve the Individual Coverage Health Reimbursement Arrangements that would give employees more options of health coverage with tax-preferred dollars.
• The third vote reauthorizes the landmark SUPPORT Act(the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Reauthorization Act of 2023). All three bills build on Trump administration policies. President Trump signed the original substance abuse law in 2018 to address the nation’s opioid and mental health crises.  This legislation also has bipartisan support in the Senate.

The House of Representatives has now shown that there is bipartisan support for improving our healthcare. It’s time the Democratic-controlled Senate do the same for the sake of the America people. Let’s hope both sides can come together, even in an election year, to put the American people ahead of partisan politics.