Dear Dr. Roach: I was recently diagnosed with Type 2 diabetes. I have read all sorts of pamphlets and brochures; I have been to classes at the hospital to learn about managing this disease; I have seen the vast array of supplies for testing blood sugar at my local pharmacy. I have come away with a theory.
There is too much money being made in treating and helping folks manage their Type 2 diabetes. A whole industry has been built around this. As a result, there never will be a serious attempt at finding a cure, because as soon as there is a cure, this industry will be out of business and these companies will no longer be able to make a profit. What do you think?
T.B.
I hear variations on this theme from time to time, especially about cancer. While I admit that suppressing a cure in favour of control would be a successful business model, there are so many different researchers from so many different countries, academic institutions and companies that it would be impossible to keep a cure secret.
More importantly, the profit motive certainly is a driving force in medical research, but it is by no means the only one. Young and idealistic (and brilliant) researchers have made this career choice largely out of an altruistic desire to help. If you鈥檙e in it for the money, medical researcher is an unwise choice of occupation.
I wouldn鈥檛 discount the scientist鈥檚 desire for personal glory, either. Researchers dream of being the person to make the key discovery that leads to a cure for this disease, which affects 44 million North Americans and 415 million people worldwide. The payoff for a cure for diabetes likely would be very large, too.
Type 2 diabetes isn鈥檛 one single disease, and a cure has been elusive. For now, successful control depends on commitment by the person with diabetes to a healthy diet and exercise (as much as is possible) and by a knowledgeable team, including the physicians, nurses, nutritionists, educators and others who help manage this (so far) incurable, but controllable, condition.
Dear Dr. Roach: I鈥檓 a 77-year-old man. My doctor has me on a statin for slightly elevated cholesterol. He says it鈥檚 鈥渋nsurance,鈥� but I would like to stop taking drugs that may not be necessary. My cholesterol is 160, triglycerides 67, HDL 65, and my blood pressure is 120/80. I have no history of any heart issues. Do you have to taper off a statin, or can you quit cold turkey?
H.C.
Even though your cholesterol numbers and blood pressure are nearly optimal, the risk for a healthy 77-year-old man to have heart disease in the next 10 years is high: 22 per cent, according to the most common calculator (at cvriskcalculator.com). A statin can reduce that risk, possibly by as much as five per cent. A statin is recommended for people with heart disease risk this high. Most experts think statins work via multiple pathways, not just by lowering cholesterol.
If you decide to stop, you can stop. However, the rate of heart attack, hospitalization and heart failure is significantly higher in people who stop suddenly or slowly, compared with those who continue, especially in the first six to 12 months.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
