Trump's FDA Commissioner: Stop Taking Insulin And Learn To Cook

Diabetes affects somewhere around 12% of Americans. There are basically two types of diabetes (with a few details I’m leaving out for simplicity’s sake): type I, as described in the first quote above and represents about 10% of diabetics, and type II, the most common type.

Type I diabetes is an autoimmune disease that destroys the cells that make insulin. Type I diabetics will die quickly without insulin, or, as in above account, could live a bit longer and starve to death instead.

Type II diabetes is a complicated blend of genetics, lifestyle, and other factors. The stereotype of a type II diabetic is a fat, lazy American who sits around washing down bags of Fritos with bottle after bottle of pop. As is usually the case, it’s a lot more complicated than that.

In contrast to type I diabetics, type II’s often make lots and lots of insulin—their bodies just can’t use it very well. Insulin resistance is complicated, but one of the risks is obesity. Many type II diabetics will eventually “burn out” their pancreas and become dependent on insulin.

So that’s the quick background. We treat type II diabetes with a combination of lifestyle changes and medications (one of which can be insulin). Treating behavioral factors is not a new thing—diabetic specialists usually have dieticians and certified diabetic educators in their practices. Doctors don’t just “throw insulin” at people.

If you are the generous type, you might say that FDA Commissioner Marty Makary was simply making a rhetorical point, not being literal. But his comments during the interview were quite typical of his past comments and writings.

Coming from some crank on TikTok, these words would be annoying. Coming from one of the most powerful people in health care, they can kill. He obviously (I hope) isn’t suggesting withholding insulin from anyone. And he makes an important point that lifestyle matters in diabetes.

But his attitude is a common one among the sorts of people now running our major health and research agencies: modern medicine is a predatory industry that wants to make money and doesn’t care about root causes of disease.

There are so many ways that this is wrong that I simply cannot address them all in a short piece, but here are some critical points:

• Doctors absolutely care about treating the root causes of disease, not just symptoms. If he doesn’t think that’s true, he doesn’t understand medicine.

• We cannot and should not withhold treatments from people because of their “bad behavior”. Medication and lifestyle compliment each other, but cannot replace each other.

• People who fail to make enough lifestyle changes are not bad, are not failures, and do not deserve our condemnation. Life and biology are so much more complicated than that.

Language like Makary’s is harmful, as are many of his and HHS secretary Robert Kennedy’s policies. They have stated both explicitly and through policy choices that they believe most disease is a behavioral problem. They believe that ultra-processed foods are the cause of diabetes (which has a glimmer of truth only) and that “toxins cause cancer” (some toxins can cause some cancers, but that’s not really how it works). They believe that kids get too many vaccinations. They believe that fluoride is harmful and they don’t just want to take it out of drinking water, but ban it as a medication as well. Strangely, they think that non-pasteurized (“raw”) milk is a good thing rather than one of the largest killers of children in the days before pasteurization.

Our entire federal health infrastructure has been taken over by quacks and cranks. Dr. Oz, a charlatan whose claim to fame is selling a different supplement every five minutes, is in charge of Medicare and Medicaid. Robert Kennedy, who believes that MMR vaccines cause autism, is the head of Health and Human Services. Jay Battacharya, who believes the best way to deal with covid is to catch it¹ , is running the National Institutes of Health.

Whether or not your political beliefs are in sync with the current administration, your health and the health of those you love is in danger because of these appointees and these policies. The harm is not in some distant, theoretical future—it’s now. This fall, access to covid shots will be severely limited, which will lead to more hospitalizations and deaths. And that’s just one of their smaller policy decisions.

I don’t know what to tell you other than it’s important to know what’s going on, and to reach out to your representative today, tomorrow, and every day so that they know Americans will not tolerate dangerous quacks running the health institutions that were the envy of the world.

Stay well.

-pal

1  “As immunity builds in the population, the risk of infection to all – including the vulnerable – falls. We know that all populations will eventually reach herd immunity – i.e. the point at which the rate of new infections is stable – and that this can be assisted by (but is not dependent upon) a vaccine. Our goal should therefore be to minimize mortality and social harm until we reach herd immunity.” (Great Barrington Declaration). NB: This statement is false. “Herd immunity” is the idea that if enough people are immune to a disease, it has nowhere left to go. But with a disease like covid, that you can catch over and over, herd immunity is not possible.