Diabetes 2 Is Like Having A Job

I have diabetes type 2.  To say it's been a struggle is an understatement.  I love bread, pasta, cereal...basically carbs.  Last fall I had a rude awakening and my A1c jumped to very high and dangerous levels after stable for quite some time.

After having the "scary talk" with my new doctor and being put on a new medicine cocktail (but no insulin), I re-committed myself to diet and exercise.  In three months, I dropped ~8 pounds and lowered my A1c to 6.5.  Quite an accomplishment.  She was amazed and I was very proud.

And then 2018 hit.  Stress eating returned. Lots of stress in January and February.  Then my wife and both struggled with illnesses throughout March.  I was forced to take a steroid for a week.  I ate like crap and couldn't exercise (bronchitis).  Late night snacking, too.  I put on a few pounds.

So, I saw my doctor yesterday and I got the results that I expected.  My A1c had jumped dramatically and I gained back some weight.  Then I got the lecture.  "Diabetes2 is a progressive disease...you have to get back to eating better...exercise more..."  Blah, blah, blah.  Heard it for years.

But then she said something that really hit home:  "Diabetes 2 is like having a job."

You can't go to work on a Monday and do your job well.  Then on the next day, tell your boss that since you did so well the previous day, you are not going to work today.  You need to do your job EVERY DAY or else you'll lose your job.

Diabetes 2 is just like this.  It's a job that you have to do each and every day.  Eating well and exercising yesterday doesn't excuse one from the obligation to do the right thing today.

So, I am now I have to start thinking as if Diabetes 2 is my permanent job.  The big difference is that instead of just losing my job if fail to work consistently, I could lose a foot if I don't do my Diabetes job.

That's pretty good motivation!

P.s. - Last night was day 1 without late night snacking!

The Costs of Not Going to the Gym ($500 Billion)

Most of us know that we should be eating healthier and exercising more.  It's not a complicated formula.  And yet, the statistics on preventable illnesses are staggering.  Here's just a small sampling:

• Nearly 10% of the US population has diabetes (~30million)
• Approximately 1.4 million new cases of diabetes reported annually
• 30% of all Americans are obese
• Obesity related illnesses account for ~$200b per year in health costs
• 17% of all Americans over 18 are tobacco smokers
• Another 16 million Americans live with a smoker.
• Smoking causes $300b a year in health costs and lost productivity
• Cigarette smoking is responsible for 480,000 deaths per year and is the leading source of preventable deaths

(sources:  American Diabetes Association and CDC) 

The statistics on exercising are not very good either:

• 191 million Americans (60%) don't get the recommended amount of weekly exercise
• 25% don't exercise at all (79 million people)
• # of gyms in the U.S.:  30,500
• # of Americans with gym memberships:  58million
• % that don't use their memberships:  67%

(sources:  CDC and StatisticBrain) 

The average cost of a gym membership is about $60 per month.  That's $720 per year.  Many diabetes medicines cost far more than this.

So let's generously assume that there are ~85million people in the U.S. (27%) with a preventable illness.  If the government spent $720 per person on a gym membership for each of them, the cost would be $61billion per year.  

So the big question is:  could this $61b reduce health care spending by more than that amount?  If ~$500b is being spent on preventable illnesses, that means that it would have to result in 12.2% savings.

I haven't found any conclusive studies one way or the other.  But, personally speaking, I prefer the idea of spending $61b on gym memberships as opposed to the same amount on diabetes medicine.  

Of course, the big problem is how to encourage (or require) that people use their gym memberships?  Any solution would certainly be very controversial (just ask any ACA opponent about the mandate).