In the News: Startup Creates Marketplace For Diabetes Prevention Programs

My “times have changed” file seems to get bigger by the day. When I was a medical student more than 40 years ago, we were taught several things about type II diabetes—we used the Roman numeral back then. It was rare, affecting less than 1% of the population. That it was a so-called lifestyle disease that could be influenced by the way people ate, how much they exercised, and the pounds they gained or lost. And that it could be brought under control with sulfonylurea drugs, such as acetohexamide, chlorpropamide, and tolbutamide, or one or more of the several different varieties of insulin derived from the pancreases of pigs and cattle.

The sulfonylurea drugs are now almost relics, replaced by scores of other medications and an array of combinations. Recombinant DNA techniques have made harvesting insulin from animals obsolete. Yet despite the truly mindboggling amounts of money and effort spent on research into the pathophysiology of diabetes and its treatment, the disease is now almost 10 times as common as it used to be and is predicted to climb to catastrophic levels by midcentury, partly because people are getting heavier and heavier.

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