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RE[IP] Cure for diabetes? HA! [VERY LONG response]

Ginny Kloth <email @ redacted> wrote:

> I will have to agree to disagree with you on this topic. 
> There is alot to
> lose for all sorts of pharmaceuticals if there is a cure 
> for diabetes and
> other illnesses. And I doubt there will be a cure because 
> then no one would
> have to buy test strips, insulin pumps, blood testing 
> machines, syringes,
> insulin and all of the gadgets that go along with all of 
> these things ANd
> if there is a cure I doubt many people would be able to 
> afford it and most
> insurance companies would deny it saying it is a 
> experiemental procedure so
> those that are wealthy would be the ones who would get a cure.

<< SNIP >>

Wow! You are certainly entitled to your opinion, and you've certainly
experienced a lot of pain and my heart goes out to you.

But let me address a couple of points here.

First of all, I have no great love of pharmaceutical companies.  In fact,
the latest issue of the New England Journal of Medicine contains a scathing
editorial chastising pharmaceutical companies for not putting more back into

And, it's true, that they may stand to lose quite a bit of income if
diabetes is cured.  But here's the rub: there won't be *a* cure for diabetes
because diabetes is not *a* disease. Diabetes is really a collection of
symptoms, primarily high blood sugar and associated problems which may be
caused by malfunctioning islet cells, dead islet cells, loss of a pancreas
due to injury, insulin resistance due to a flaw in the protein transport
chain within the cells so that they don't easily admit glucose through the
cell wall, conflicting hormones as in gestational diabetes, and probably a
lot more other factors.

And here's the next part: pharmaceutical companies control neither the
protocol nor the funding for research of diabetes (much as they might like
to), so they have no control over what treatments, preventatives, etc., will
be available in the future.

Also, I have no particular affinity for insurance companies, and here we
have, again, some effect, but not as much as one might think. While most
insurance companies will not cover experimental drugs, procedures, etc.,
most of these are given to the subjects free of charge. Similarly, a
pharmaceutical company may *NOT* ask a patient using an experimental drug
(i.e. is part of a clinical trial) to pay for the drug. So, again, the cost
of experimental procedures is not borne by the insurance companies, so they
have less influence.

About 80% (maybe more) of insurance coverage is either directly or
indirectly controlled by the Health Care Finance Administration (HCFA) which
administers Medicare.  For most coverage, insurance companies will cover
what Medicare covers.  That's why there is currently a big jump in coverage
for insulin pumps -- as of April 1 of this year, Medicare will pay for a
pump for type 1 diabetics who qualify for Medicare.  Going along with this,
most insurance companies will now also cover pumps for type 1 diabetics.  I
suspect it won't be too long before this is expanded for type 2 diabetics.

Ultimately, the source of knowledge and subsequent treatments for diabetes
is in the hands of academia, not pharmaceutical or insurance companies.
Most of the funding of these projects (at least in the United States) is
from the National Institutes of Health, and some private organizations like
the American Diabetes Association, the Robert Wood Johnson Foundation, and a
few others.

> one of the biggest lobbying groups in the US. In fact the chemcial
> companies have a huge influence on the US Government. I 
> have been trying to
> get information and some forms from the disability office 
> from the DOJ and
> after 4 months and phone calls I still have not recieved 
> it. So much for
> how my tax dollar helps me.

What forms are you trying to get?  Have you tried on line?
http://www.usdoj.gov/crt/ada/adahom1.htm is the web site for the DOJ ADA

> We have been hearing for years there was a cure 
> just around the
> corner..

>From whom?

> well.,alot of corners have come and gone and no 
> cure as of yet., My
> grandfather who was one of the first ones in insulin when 
> it first came out
> in the 1920's was told there would be a cure for him..well 
> he is gone now
> from the complications of diabetes and my mom will never 
> have a cure and I
> won;t so exactly what is holding it up?

I'm sorry about the loss of your grandfather, but to put this in some
perspective, it's worth asking a couple of questions. First of all, how long
did he live with diabetes?  How long would he have lived without insulin?

"Cure", you see, can be a relative term.
> You are from the CDC..Which is another dept of the US 
> Government who still
> has not come up with help for those with chemical injury or 
> those suffering
> from Gulf War Syndrome..and you expect me to read and 
> believe what you will
> write up? 

The problem with this is that the CDC is not involved with wartime injuries
as they don't pose a general public health risk.  I agree that many
servicemen have been treated shabbily.  

OTOH, NIOSH and OSHA (both offices within CDC) are very *MUCH* interested in
*PREVENTING* injury from chemical sources.  CDC's mission is *prevention*,
not treatment.  Treatment for veterans is the mission of the Veteran's
Affairs Administration.

But I suspect that nothing I can say is going to convince you of any of

> My dad was one who was experimented 
> on during WWII
> with various gases and it was not until the mid 1990's that 
> it was made
> public. 

There are several black marks in the history of health research in the
United States. One of the worst was the Tuskegee Experiment in which African
American men who were thought to have syphilis were left untreated so that
researchers could study the course of the disease. The government has
formally apologized and offered restitution to the victims and/or their

Since then, we have a strict code of ethics for all research carried out
directly by government agencies, as well as research funded by the U. S.
government. Under these rules, all projects that involve human subjects are
required to undergo at least one Institutional Review Board (IRB) inquiry
which verifies that direct study of human subjects is necessary to the
project; that the project itself has sufficient research significance that
it should be carried out; that all participants have made informed consent
after having been fully informed of the purpose of the project, the risks
involved, and the expected gain; and that confidentiality will be
maintained. No project may be carried out by government researchers without
this review, and all participants must be certified that they have received
the necessary training to understand these ethical issues (FWIW, I hold
Department of Health and Human Services CDC certificate number 15679). 

Another aspect of the ethics training involves conflict of interest which
assures that private concerns to not hold influence in the decision making
process regarding either the carrying out or funding of research projects
(i.e. pharmaceutical companies, insurance companies, chemical companies,

No government agency may fund research that does not meet these criteria. 

> There is alot 
> of secrecy in the
> US government and it is not for our good. It takes away from us. 
> I don't believe there will be a cure for AIDS either sadly 
> or for FM or MS
> or RA. All that happens is that more meds come out to take 
> care of the
> symptoms..like a band-aide does .but nothing cures . Too 
> much $$$$$ loss if
> there was a cure.

Now this is just nonsense.  Just under 30% of CDC's budget is HIV/AIDS
related (my salary is paid from AIDS funding).  Never in the history of
biomedical research has more been learned about a virus and a disease in
such a short time as we have learned about HIV and the mechanics of
HIV/AIDS. Research to find a cure goes on at a tremendous pace, *ALONG* with
research in how to treat those who have the disease. In addition (and most
important!) is that considerable progress is being made in the development
of a vaccine to prevent the disease in the first place.

And regarding secrecy, I suggest you visit the DOJ web site (see the earlier
link) and click on Freedom of Information Act.
> Well this is part of my soap box. I have seen the lies and 
> have dealt with
> the US Gov too much to hold much trust and faith in them.  

As I said, I don't expect this post to change your mind. I wouldn't be
surprised if you consider all of what I've written here as one more set of

But I can hope . . .

Jim Handsfield
Centers for Disease Control and Prevention
mailto:email @ redacted OR
mailto:email @ redacted

The opinions expressed are my own and do not necessarily represent those of
the Centers for Disease Control and Prevention, the United States Public
Health Service or any other agency of the United States government.
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