November 19, 2025 • 32 mins
Hari and Priyanka explore a breakthrough in Type 1 Diabetes treatment, spill the tea on the Ozempic cash scandal, and gush over the King of Fruits, the mango!
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Speaker 1 (00:00):
This podcast is for information purposes only and should not
be considered professional medical advice.
Speaker 2 (00:05):
Oh not eating one hurts the soul.
Speaker 1 (00:11):
Something I want to get your take on.
Speaker 2 (00:14):
Is it about baseball?
Speaker 1 (00:16):
No?
Speaker 2 (00:16):
No, so whenever, like pharmaceutical companies do studies like are
they dubious? Yeah, system's broken. I'm hurry, condibolu. I'm doctor
pre uncle Wally, and this is health stuff. Hey, Prianca, Hey, Hello,
(00:43):
how are you? I had to get a root canal?
No way. I always thought root canals were going to
be super painful, but they're not that bad.
Speaker 1 (00:51):
Actually, they medicated you fairly nicely.
Speaker 2 (00:55):
Right, Yeah, that part was painful. They had they injected
the inside of my mouth, which I didn't like very much,
but it was effective. I always wondered, though, this is
a question that's been in my mind for a while.
How do doctors view dentists?
Speaker 1 (01:09):
Oh, with love and respect. If that's when you're asking,
I mean, to me, it's like a it's a specialization.
It's the doctor of the mouth and the teeth and stuff.
I mean, I really appreciate dentists because if there is
a patient that has dental issues, like I feel very
relaxed that I can say like, oh, you need to
(01:31):
see a dentist, Like this isn't my jurisdiction. And I
really appreciate the work that they do do they go
to med school, they go to dental school, which is
different than medical school, and they just spend I think
it's four years. They spend several years just focusing on
mouth teeth. And I actually like what dentists do because
(01:51):
they do a lot from a public health standpoint about
like how your diet impacts your teeth, and we know
like gum health is a very big telltale sign of
what's going on from a heart disease standpoint that if
you have inflamed gums, you better check your arteries for
inflammation too. I think brushing your teeth is such an
(02:12):
amazing human invention. Like props to the dental associations for
doing that.
Speaker 2 (02:18):
This is so much more positive than I hoped it
would go. Oh did you think.
Speaker 1 (02:22):
I was gonna like rat on dentists.
Speaker 2 (02:25):
Dentists or wag Okay, dentists are just crappy doctors. They
can't do any things that work on your teeth. Oh
you have a cold, don't go to a dentist. They
don't know anything okay.
Speaker 1 (02:37):
I will tell you that when I was performing stand
up comedy and I would do crowd work and I'd
say like, are there any doctors in the audience? And
if someone raised their hand and was like yeah, and
I'd be like, what kind of doctor are you? And
they'd be like a dentist? Yeah, I would like make
fun of them hardcore. I'd be like, oh, if someone
had a heart attack, you're gonna be like, I'm gonna
take your roucanal out.
Speaker 2 (02:57):
Or do they view themselves as.
Speaker 1 (03:01):
I think they can? They refer to themselves as doctors.
I mean they have a doctorate in dentistry.
Speaker 2 (03:09):
Yeah, but is that is that? Isn't that like getting
a doctorate in literature?
Speaker 1 (03:12):
Hey, look, you got to give dentists some props. I mean,
come on, like they I love that they're all about
like avoiding sugar and flossy. I think is wonderful. I'm
definitely on the pro dentist side. And now, like I
refer a lot of patients to dentists who've gotten sub
specialized in sleep medicine, so now they're dentists that specialize
(03:36):
in sleep apnea. Love those people, But are you okay?
Status pus root canal.
Speaker 2 (03:41):
Yeah, yeah, I'm good. I gotta They've filled it up
with something and now I have to get a crown.
Speaker 1 (03:47):
Oh nice, so you'll be a real king. Wait did
you have braces growing up?
Speaker 2 (03:53):
No?
Speaker 1 (03:54):
Oh, okay, because I had braces, and that they like
scared you when you get brace is they're like, if
you do not brush your teeth twice a day minimum,
like all of your teeth will fall out and you
will be shamed, like for the rest of your life.
I was scared. I was so scared. So I learned
to brush my teeth twice a day religiously because of
(04:17):
that experience, and now that's a residual effect. I still
to this day brush twice a day, mostly from the
fear mongering.
Speaker 2 (04:26):
Now, Pranka, I want to get your take on something
I read last week and I think is very much
in your wheelhouse. Okay, So I was at home reading
the New England Journal of Medicine, like I do not really,
not really. I was just scrolling and hopping around the
Internet looking for something to talk about in the show,
and I came across a New York Times article from
(04:48):
early June about what sounds like a pretty big study
that was published this summer in the aforementioned New England
Journal of Medicine, which I know is an important right,
that's a big one.
Speaker 1 (05:01):
Yeah. I would definitely say it's like top three for sure.
Speaker 2 (05:04):
That's like the oscars of Yeah, it's like up there
for sure. Yeah. Well, basically, this research article is saying
that they tested a new experimental stem cell treatment on
individuals with severe cases of type one diabetes and they
saw some really promising results, like you could potentially cure
type one diabetes.
Speaker 1 (05:24):
Yeah, I'm familiar with that article. I remember looking it
up and going through some of the details.
Speaker 2 (05:29):
I mean, so like it's incredible, But then like you
have layman like myself, like I don't know anything about
diabetes other than I don't want it.
Speaker 1 (05:36):
Well, lucky for you, I'm here. So type one versus
type two. Type one is actually an autoimmune disease. Basically,
the person with type one, their body destroys their own
pancreas cells that make the insulin. So it's like an
(05:58):
attack on the cell. And why is this significant? If
the pancreas cells they're called islet cells, if they can't
make insulin, the person actually needs to be on insulin
for the rest of their life. They need to take
it as a medicine. Type two is very different Type one.
They're not making any insulin. Type two. They're making their
(06:20):
own insulin, but there's issues with the quantity that's being
made or how the body's responding to it, and our
environment plays a big role in that is specifically what
we eat. So this study was crazy, like huge because
type one, we've been told is like you live with it,
(06:41):
you take insulin for the rest of your life, and
there's no cure.
Speaker 2 (06:45):
Like Type two is reversible in theory.
Speaker 1 (06:47):
Right, yeah, very much in theory. In practical cases it
can be put into remission.
Speaker 2 (06:53):
But type one is the assumption has always been like this,
it's an autoimmune disease and you.
Speaker 1 (06:58):
Have it, yeah, and you need to be on insulin.
Speaker 2 (07:01):
So this is clearly like a huge deal. Like fourteen
people were in the study. Twelve made it to the
final stage, but ten people were cured. Essentially after one
year they no longer needed insulin, which means they were
making their own insulin. Is that right, Yeah?
Speaker 1 (07:17):
Yeah, I mean you're bringing up some interesting points, like
this is a small study. First of all, One other
quick note about this study that I just wanted to
mention I was able to get my hands on the
appendix of this original article published in the New England
Journal of Medicine looking at stem cell derived fully differentiated
(07:38):
islets for type one diabetes, so basically looking at using
stem cells for people with type one diabetes. And actually
it turns out that they enrolled initially twenty three people
and started them on the immunosuppressive therapy, but they actually
ended up dosing twenty two people in total, fourteen which
(08:01):
the main paper states the catches that they were only
able to follow fourteen people for more than a year
out so why the other eight individuals were lost to
follow up isn't clear. It wasn't mentioned in the study,
So I am curious, you know, did they have side
effects and just quit or what exactly happened. Of course,
(08:22):
there could be a lot of reasons why people fell
out of the study, because that happens in research, right
like people move, they have life issues. The bottom line
is that you know, again this is a very small
sample size, but it is it is a little bit
interesting this extra information. But yes, to be clear, eventually
there were people that were initially insulin dependent type one
(08:46):
people with diabetes now requiring zero insulin, they were making
their own insulin.
Speaker 2 (08:52):
How does this treatment work?
Speaker 1 (08:53):
Okay, so this is it's wild because what the researchers
did is they used stem cells, which essentially they grew
these stem cells in a lab and they turned them
into the pancreatic islet cells.
Speaker 2 (09:08):
How do you know how they do that? How do
you do that?
Speaker 1 (09:10):
Well? So all stem cells are are they're special cells
that can grow into other types of cells. And this
technology has been around for a while before studies like
in humans. They were doing this on rats, so I'm
sure it took a lot of rats for them to
figure out the right kind of cells. But at some
point along the way they figured out, okay, we can
(09:31):
grow pancreatic cells in the lab. Then they gave the
patients the pancreatic cells. They infuse them through the portal vein,
which carries blood to the liver. So they had these
ports put in them and they had infusions done, and
then once they were put in their body, they just
(09:52):
gave these pancreatic cells time to just settle in and
start making insulin. What's really important about this study is
that because remember type one is an autoimmune disease, so
the body attacks the pancreatic cells. These patients were given
medicines to suppress their immune systems so that these new
(10:13):
cells wouldn't be destroyed. And they sort of hoped that, Okay,
we're going to transplant these lab cells and hope and
suppress their immune system and hope that these people their
body can make the insulin or at least require less
insulin because they can make their own.
Speaker 2 (10:31):
Doesn't that make them incredibly vulnerable to other sicknesses and disease.
Speaker 1 (10:36):
That's exactly it. So they were immuno suppressed, right, and
the most common majority of the participants, around seventy percent
of them, mostly had diarrhea and headache some of them.
Three of those participants, their blood counts dropped really really low.
It's called neutropenia, and they were hospitalized where they needed
(10:58):
to be observed. There were two participants that died, but
the study, the people that wrote the paper said like,
they don't think it's related to the immunosuppression that they
were given, because, Okay, the two people that died, one
person died of meningitis and specifically they got Cryptococcus meningitis,
(11:18):
which happens in people who are immunocompromised. But they're saying
that actually a year and a half after they got
their infusion, this person had sinus surgery and there were
complications of the sinus surgery and they were on high
dose immunosuppressants for a long period of time because of
that surgery, and that's how they got meningitis, because the
sinus got compromised and then something went into the brain
(11:41):
and then the person died. The second person who died
in the study actually had severe dementia. And this person
had a traumatic brain injury from a car accident from
a time that they had hypoglycemia when they were having
Type one. So unfortunately that person died because they developed dementia,
(12:04):
which was just like a progressive complication. They don't think
it's related to getting immuno suppressed.
Speaker 2 (12:10):
God, that must have been like so awful for the researchers.
Like two people died and they have to explain it away.
Speaker 1 (12:16):
I mean that's research, right, Like that's right, that's like
the whole point.
Speaker 2 (12:20):
Of they didn't die because of us. We didn't do
it reptelling you.
Speaker 1 (12:24):
I mean, I think not though, is this study was
funded by the pharmaceutical company that makes the medicine that
makes the stem cells, so like they obviously have an
incentive to putting their best face forward. And the bottom
line is, I think we need like a much larger study.
We need to study this in a bigger population. I mean,
(12:47):
it's very promising. They ended up proving that these individuals
were making their own insulin, which is incredible, Like they
scientifically proved that because at the beginning of the study
they checked a blood value in these people called sea peptide,
and seapeptide is a blood test you can order. It's
a precursor for insulin, So you can check a sea
(13:09):
peptide level on someone and determine are they making their
own insulin. At the beginning of the study, these people
had sea peptide levels that were undetectable, and at the
end of the study they had sea peptide levels that
were highly detectable, which indicates that they began producing their
own insulin.
Speaker 2 (13:29):
Amazing. Yeah, how common is type one diabetes? And like,
what are the implications of this? Like, now that this
research has happened, where are the next steps? Does a
drug get mass produced? What happens from here.
Speaker 1 (13:42):
I think it's still way too early to start the
mass production. We don't know how much this would cost
the average person. Type one diabetes affects over eight million
people around the world, so it's a it's a small number,
but it's still significant. The other to remember about this study,
which I think is really interesting, they pre selected people
(14:06):
who had at least two hypoglycemic episodes in the previous year,
So these are people with type one where they were
having hypoglycemic complications. Not everyone that has type one will
have a hypoglycemic episode, so they pre selected like the
more difficult population, and I think we just need more time.
(14:27):
I think this is very exciting. This is like a
big deal. I think though, we need to do bigger studies.
And also it would be nice if we had another
study that was funded by not the pharmaceutical company that
is interested in making this work. If we can have
(14:48):
a different kind of study and then really look at
it very objectively, I think that would be very interesting.
Speaker 2 (14:53):
So whenever, like pharmaceutical companies do studies, like, are they dubious?
Speaker 1 (14:59):
Not always?
Speaker 2 (15:00):
It is not always.
Speaker 1 (15:01):
I think it's just important to follow the money, like
who has an incentive in making this work right, right, right, right.
So that being said, I think this is super cool.
I think it's super promising. And if someone would Type
one is listening, I would love to hear what you think,
you know, because you're the one living with this.
Speaker 2 (15:20):
Is this potentially the end of diabetes?
Speaker 1 (15:23):
I think it's definitely a promising start, right, but more
to come.
Speaker 2 (15:30):
This is healthstone. Right after this break, we'll be back
with some more. So I'm gonna shift the conversation a
little bit because we've been talking about type one diabetes.
Let's go to type two diabetes. Yeah, And this article
is for obvious reasons. It's it's very special to both
of us because when people think of Indian people, there's
(15:52):
two things that obviously come to mind, diabetes and mangoes.
I doubt that's the case where people are looking at us.
I'm like diabetes and mangoes.
Speaker 1 (16:02):
But I can say that's what Indian people think about
when they think of India.
Speaker 2 (16:08):
Yeah, it's like diabetes and mangoes. There's conventional wisdom that
because mangoes are so sweet, people with type two diabetes
have to avoid eating them. But Indian mangoes are gods.
Ambrosia and not eating one hurts the soul.
Speaker 1 (16:25):
I mean, ain't that the truth? Man?
Speaker 2 (16:29):
So research was done in India and they studied and
compared glycemic levels of people who ate mangoes with those
who ate plain white bread, and they found that folks
who ate mangoes had a similar or lower glycemic response
to the white bread people. So I think it's this
very very good news for the world because mangoes are
the king of fruit and Indian mangoes are the king of.
Speaker 1 (16:51):
Kings, right and now with your crown on your tooth,
I mean, oh, oh, my God, like so royal. God,
I love me. I love that. I mean just I remember,
like as a kid when I would be in India, like,
just mangoes tastes sweeter there. I mean, it's so, it's
just so wonderful.
Speaker 2 (17:11):
Oh, it's hard to explain the rest of the world
that you like, your mangoes are fine, because mangoes are incredible,
But like you don't even know, you don't know, you
don't know. I was talking to Kamail Nanjiani and he
was talking about Pakistani mangoes and he was saying that
his wife tried Pakistani mangoes for the first time, like
(17:32):
he had some ship and just she couldn't talk, like
she was just absolutely floored by the incredible taste of
South Asian mango.
Speaker 1 (17:41):
Oh yeah, and you know in India there's there's literally
over a dozen varieties, so many types of mangoes, you know,
and like local pride, North Indian mangoes, South Indian mangoes.
It's yeah, I.
Speaker 2 (17:54):
Mean common with you know, people generally say that the
Alfonso mango is the greatest of all Indian magas goes,
but I think the Bengana bully has A was a
pretty good case.
Speaker 1 (18:05):
Oh my gosh. Yeah, No, this was a fun study
to look at. It actually made me laugh out loud.
Speaker 2 (18:12):
Well, there's one thing I don't understand, Prianka. Yeah, so
they compared people who ate mangoes and like white bread. Right,
so this just tells us white bread is bad for us,
because who's making the choice between mangoes and white bread?
Speaker 1 (18:27):
Exactly? Yeah, No, I completely agree. To get really granular
about the details of the study, they had people for
eight weeks. They measured out the mango two hundred and
fifty grams of mango pulp, which is equivalent to one mango.
Speaker 2 (18:44):
With this one small mango one.
Speaker 1 (18:48):
Okay, fine, that's fine, but I love this. They also
gave them two hundred milileters of amel brand milk Amol brand,
if you know, you know. That's all I'm gonna say.
And then the other group got and they measured it
out eighty one grams of white bread, the Harvest Gold
(19:09):
white bread. It's like they named the brand, which is
it's equal to about two pieces of white bread with
a glass of milk, the Omolbran milk. And so the
rest of the day people ate the same exact type
of food. It was like calorie match for the rest
of the day based off of like Indian guidelines. And
then they looked at baseline like blood sugar weight, cholesterol,
(19:32):
body mass, skinfold, thickness, insulin levels, and then yeah, essentially
compared to the white bread eaters, the mango eaters had
lower blood sugar, better cholesterol, less belly fat and this
was statistically significant. So, I mean, just to me, this
is like, how much more evidence do you need that
(19:54):
processed foods are bad for you?
Speaker 2 (19:58):
I mean, say anything about the mangoes though.
Speaker 1 (20:02):
Yeah, so they actually did two different types of mangoes.
There were two different species from two different parts of
the country. So both of those mangoes outperform the white bread.
Speaker 2 (20:15):
But is it fair to say that a lot of
things would outperform the white bread?
Speaker 1 (20:20):
Oh yeah, I think yes absolutely. I mean I processed
foods are really a problem, Like we are not accepting
this enough in our society across the world. All this
study tells me is that this is a statement on
the harmful effects of white bread. That it's like literally
better teat mangoes than it is heat white bread. I
(20:41):
still think someone with type two diabetes would benefit from
a carbohydrate reduced diet because we know type two diabetes,
which is related to having high insulin levels, that's all
controlled by carbohydrate intake. So if you don't eat as
many carbohydrates, which includes sugars and processed foods, your insulin
(21:03):
demand will go down and the type two diabetes won't
be as severe.
Speaker 2 (21:08):
So how big is type two diabetes globally huge?
Speaker 1 (21:12):
It's huge. According to the International Diabetes Federation, diabetes cause
two point four million debts in twenty twenty four and
five hundred and eighty nine million adults are currently living
with diabetes worldwide, and that's expected to go up to
eight hundred and fifty three million by twenty fifty in
the United States. I mean, fifty percent of Americans are
(21:35):
pre diabetic.
Speaker 2 (21:36):
How preventable is type two extremely? Like, what would we
have to do or avoid societally to not have the
numbers that we're having.
Speaker 1 (21:48):
I think what would be very helpful is if the
government actually stops subsidizing corn, which then allows for the
creation of highly processed foods dating high fructose corn syrup.
A lot of foods that are cheap are very high
in carbohydrate and very processed, and those are the exact
(22:08):
foods that cause diabetes, right, And so I don't think
people intentionally want to eat food that makes them sick.
I think sometimes economically they're forced to not really have
a choice. And so the first thing we need to
do is shift the economics around what people can afford
so that they are eating more nutritious food that's unprocessed
(22:33):
and doesn't raise their insulin levels. But in my private practice,
Just and I have taught this course at UCSF for
many years, helping people have type two diabetes put their
diabetes in remission using low carb diets which really work.
Like I have personally had patients who were on insulin
(22:54):
because of type two diabetes that they were able to
get off of insulin with just carbohydrate reduction.
Speaker 2 (23:01):
Wow.
Speaker 1 (23:02):
And that's not like, you know, no prescription, like it's diet, right.
So I really believed so much of type two diabetes
is because of what's going on environmentally. And I do
think that we could make massive legislative, economic, environmental changes
that could change the health of our country for sure.
Speaker 2 (23:24):
So what's the story with this harvest gold bread? Is
it different than other kinds of white bread? Is it
any worse or so.
Speaker 1 (23:32):
Harvest gold white bread is? I mean, it's super processed.
I actually found the ingredient list from the actual label.
Number one ingredient refined wheat flour. Sixty four percent of
that is you know, good real bread should just have
flour and water and that's it. Second ingredient is sugar,
(23:55):
So they add sugar, yeah, then followed by yeast, salt, lutin,
and then they just put preservatives number two eighty two
and two hundred. God only knows what that is.
Speaker 2 (24:06):
God not to eighty two, not to eighty two.
Speaker 1 (24:13):
Then it goes on. They add soilflour, which is highly
processed and then edible vegetable oil, which is a combination.
They put parentheses soy oil, soybean oil and palm oil,
very highly processed oils, very inflammatory. Next ingredient emulsifiers number
four eighty one, four seventy two, four fifteen geez, followed
(24:35):
by acidity regulators two seventy and two ninety seven, antioxidant
number three hundred, and then a flower treatment agent number
five nineteen. So as you can see, this is loaded
with chemicals.
Speaker 2 (24:49):
Whenever there's a number next to the ingredient, that's like
really bad.
Speaker 1 (24:53):
There's nothing like good old organic flower treatment agent number
five sixteen. It just like Grandma used to make it. So,
I mean, the key here is that when we eat
such highly processed foods, you compare that to a mango,
which is a starch, It RECs havoc on the body.
(25:14):
It causes inflammation, and inflammation raises glucose levels and insulin
levels and all sorts of other health issues. So I'm
not surprised there's so much data already out there saying
process foods are bad, But like this study kind of
puts in your face, like please, you know, right after
this break, we'll be back with more. So, how do
(25:40):
you something I want to get your take on.
Speaker 2 (25:43):
Is this about baseball?
Speaker 1 (25:44):
No? No, But I don't know if you know, but
there's actually a fierce price battle happening between Novo Nordisk,
the company that makes ozembic with the GLP medications, or
as Trump called it, the fat shot, Oh God, and
(26:06):
compounding pharmacies, which are these type of pharmacies that make
customized drugs. A lot of them are online, and sometimes
folks go to them to get these golps for cheaper.
Speaker 2 (26:18):
I've been aware of this price battle for about five
minutes when I read the intro to the show, but
other than that, no, I have no idea. Yeah.
Speaker 1 (26:27):
Yeah, so it's a battle to see who can corner
the market. And Nova Nordisk has teamed up with this
website called good Rx. I don't know if you've heard
of it, but yeah, so it's like this expedia for
pharmaceutical drugs, and they have slashed the price of a
zempig and a gov basically in half. But obviously there's
(26:49):
a catch, right, This price is only for people who
will pay straight up cash, meaning they won't go through
their insurance.
Speaker 2 (26:58):
Yeah, system's broken. That's what is the point of insurance?
If I could just pay cash to get the drug
for cheaper, what is the point of.
Speaker 1 (27:07):
That you can buy these medications for four hundred and
ninety nine dollars instead of what is typically one thousand
dollars if you don't have insurance, right, I mean, for me,
it's like, okay, if they're dropping the prices now, it's
like what were they doing the whole time when the
prices were so high?
Speaker 2 (27:26):
You know what I mean.
Speaker 1 (27:27):
I've had multiple patients who have sought out golp ones
and we're told by the insurance like, okay, well, if
you if you get it through your insurance, it'll cost you,
let's say, three hundred dollars a month plus whatever it
is you got to meet your deductible right, which they're
(27:48):
already paying into. But then they will they'll go to
the manufacturer and be told, oh, well, if you're going
to pay us directly, it's just going to cost you
two hundred dollars a month straight.
Speaker 2 (28:01):
Wow. Yeah.
Speaker 1 (28:02):
Multiple cases of this, so it's like they have no
incentive to go through their insurance, right, And it's I mean,
this is such proof of just how messed up our
insurance system is right now, right Like we were told like, oh,
this is a system we're creating, this health insurance system.
It's originally designed we're going to lower costs for everyone
because we're going to spread costs over a larger pool
(28:25):
of people. But the reality is this is just a
transfer of our taxpayer dollars to corporations that are for profit,
have some of the highest profit margins. They're some of
the most profitable companies on the stark market. They're driving
the SMP.
Speaker 2 (28:40):
Why are they lowering the prices right now? Is it
because the demand is so high and people insurance is
not covering it or making it affordable enough, so they're
just like, okay, then we'll sell it ourselves. Like why
are they doing this right now?
Speaker 1 (28:53):
When you hear from them, they'll say things like, oh,
we are interested in capturing the individuals that don't have
health insurance and we want to make sure that they
get the coverage. You know. It's like, oh God, jag
me alrighty, like give me a break, like corporate mumbo jumbo.
(29:14):
I mean I want to say, like four ninety nine
is not like a consumer friendly price, that's like the
that's an infomercial price. Yeah, you know, like anything that's
costs four ninety nine, it's.
Speaker 2 (29:27):
Not an infomercial price because they would give you one
free along with it. If you order right now, you'd
get a second one for free. I know Bernie Sanders
described the announcement as a modest stepped forward, because that's
what Bernie would say. He's going to be like, this
is great. It's gonna be like this is because it
is a modest step. This is a quote Novo noticed.
(29:50):
The move to cut the price of a zempic to
four hundred and ninety nine dollars for the uninsured is
a modest step forward. But let's not forget ozempic costs
just fifty nine dollars in Germany, while it costs less
than five dollars to make. The US must no longer
pay the highest prices in the world for prescription drugs.
Which the biggest thing that Bernie says that would lower
(30:13):
the prices is to expand Medicaid exactly.
Speaker 1 (30:16):
I mean, clearly, for profit health insurance systems are not working,
and what we do need is a medicare for all
everyone covers everyone that is not for profit does not
have huge margins and is just intended to give people
access to care and medications that they need.
Speaker 2 (30:37):
Yeah, so drug companies are saying they're lowering prices to
compete with compound pharmacies. And this was new to me
because I'd never heard of a compound pharmacy before. But
if you've seen the ads for a startup selling low
priced versions of glps all over the internet, well, that's
a compound pharmacy. So I'm wondering, are these drugs just
to save.
Speaker 1 (30:58):
So it depends like certain like there have been some
cases where people getting it from compounding pharmacies. There's been
some adulteration. It's not pure. If you get a brandname medication,
then you know you're getting one hundred percent of that
medication down to like a very very small degree. So
(31:19):
there have been a couple of situations where people had
some untoward side effects.
Speaker 2 (31:23):
So explain compound pharmacies to me a bit more, Like,
I know they customized drugs, but why are they also
useful for physicians.
Speaker 1 (31:32):
It's a legally operating pharmacy that requires prescriptions, but they
can make doses of medications that aren't part of the
standard regimen that you would get at like a major pharmacy.
So let's say I needed a medication and I'm just
making it up. Ten milligrams was the lowest dose that's prescribed,
(31:53):
but I, for my body only wanted five milligrams. I
could go to a compounding pharmacy and they could make
it unique to whatever my needs were.
Speaker 2 (32:03):
Couldn't you also just cut the pill in hand?
Speaker 1 (32:05):
I mean, yeah, you can also just got the thing up.
But I mean that's just my example.
Speaker 2 (32:18):
Health Stuff is a production of iHeart podcasts. Don't forget
to send us your voice memos with all those pesky
health questions that keep you up at night. Email us
at health stuff podcast at gmail dot com and go
and subscribe to health Stuff wherever you get your podcasts.
Talk to you soon.
This podcast is for information purposes only and should not
be considered professional medical advice.
Speaker 2 (00:05):
Oh not eating one hurts the soul.
Speaker 1 (00:11):
Something I want to get your take on.
Speaker 2 (00:14):
Is it about baseball?
Speaker 1 (00:16):
No?
Speaker 2 (00:16):
No, so whenever, like pharmaceutical companies do studies like are
they dubious? Yeah, system's broken. I'm hurry, condibolu. I'm doctor
pre uncle Wally, and this is health stuff. Hey, Prianca, Hey, Hello,
(00:43):
how are you? I had to get a root canal?
No way. I always thought root canals were going to
be super painful, but they're not that bad.
Speaker 1 (00:51):
Actually, they medicated you fairly nicely.
Speaker 2 (00:55):
Right, Yeah, that part was painful. They had they injected
the inside of my mouth, which I didn't like very much,
but it was effective. I always wondered, though, this is
a question that's been in my mind for a while.
How do doctors view dentists?
Speaker 1 (01:09):
Oh, with love and respect. If that's when you're asking,
I mean, to me, it's like a it's a specialization.
It's the doctor of the mouth and the teeth and stuff.
I mean, I really appreciate dentists because if there is
a patient that has dental issues, like I feel very
relaxed that I can say like, oh, you need to
(01:31):
see a dentist, Like this isn't my jurisdiction. And I
really appreciate the work that they do do they go
to med school, they go to dental school, which is
different than medical school, and they just spend I think
it's four years. They spend several years just focusing on
mouth teeth. And I actually like what dentists do because
(01:51):
they do a lot from a public health standpoint about
like how your diet impacts your teeth, and we know
like gum health is a very big telltale sign of
what's going on from a heart disease standpoint that if
you have inflamed gums, you better check your arteries for
inflammation too. I think brushing your teeth is such an
(02:12):
amazing human invention. Like props to the dental associations for
doing that.
Speaker 2 (02:18):
This is so much more positive than I hoped it
would go. Oh did you think.
Speaker 1 (02:22):
I was gonna like rat on dentists.
Speaker 2 (02:25):
Dentists or wag Okay, dentists are just crappy doctors. They
can't do any things that work on your teeth. Oh
you have a cold, don't go to a dentist. They
don't know anything okay.
Speaker 1 (02:37):
I will tell you that when I was performing stand
up comedy and I would do crowd work and I'd
say like, are there any doctors in the audience? And
if someone raised their hand and was like yeah, and
I'd be like, what kind of doctor are you? And
they'd be like a dentist? Yeah, I would like make
fun of them hardcore. I'd be like, oh, if someone
had a heart attack, you're gonna be like, I'm gonna
take your roucanal out.
Speaker 2 (02:57):
Or do they view themselves as.
Speaker 1 (03:01):
I think they can? They refer to themselves as doctors.
I mean they have a doctorate in dentistry.
Speaker 2 (03:09):
Yeah, but is that is that? Isn't that like getting
a doctorate in literature?
Speaker 1 (03:12):
Hey, look, you got to give dentists some props. I mean,
come on, like they I love that they're all about
like avoiding sugar and flossy. I think is wonderful. I'm
definitely on the pro dentist side. And now, like I
refer a lot of patients to dentists who've gotten sub
specialized in sleep medicine, so now they're dentists that specialize
(03:36):
in sleep apnea. Love those people, But are you okay?
Status pus root canal.
Speaker 2 (03:41):
Yeah, yeah, I'm good. I gotta They've filled it up
with something and now I have to get a crown.
Speaker 1 (03:47):
Oh nice, so you'll be a real king. Wait did
you have braces growing up?
Speaker 2 (03:53):
No?
Speaker 1 (03:54):
Oh, okay, because I had braces, and that they like
scared you when you get brace is they're like, if
you do not brush your teeth twice a day minimum,
like all of your teeth will fall out and you
will be shamed, like for the rest of your life.
I was scared. I was so scared. So I learned
to brush my teeth twice a day religiously because of
(04:17):
that experience, and now that's a residual effect. I still
to this day brush twice a day, mostly from the
fear mongering.
Speaker 2 (04:26):
Now, Pranka, I want to get your take on something
I read last week and I think is very much
in your wheelhouse. Okay, So I was at home reading
the New England Journal of Medicine, like I do not really,
not really. I was just scrolling and hopping around the
Internet looking for something to talk about in the show,
and I came across a New York Times article from
(04:48):
early June about what sounds like a pretty big study
that was published this summer in the aforementioned New England
Journal of Medicine, which I know is an important right,
that's a big one.
Speaker 1 (05:01):
Yeah. I would definitely say it's like top three for sure.
Speaker 2 (05:04):
That's like the oscars of Yeah, it's like up there
for sure. Yeah. Well, basically, this research article is saying
that they tested a new experimental stem cell treatment on
individuals with severe cases of type one diabetes and they
saw some really promising results, like you could potentially cure
type one diabetes.
Speaker 1 (05:24):
Yeah, I'm familiar with that article. I remember looking it
up and going through some of the details.
Speaker 2 (05:29):
I mean, so like it's incredible, But then like you
have layman like myself, like I don't know anything about
diabetes other than I don't want it.
Speaker 1 (05:36):
Well, lucky for you, I'm here. So type one versus
type two. Type one is actually an autoimmune disease. Basically,
the person with type one, their body destroys their own
pancreas cells that make the insulin. So it's like an
(05:58):
attack on the cell. And why is this significant? If
the pancreas cells they're called islet cells, if they can't
make insulin, the person actually needs to be on insulin
for the rest of their life. They need to take
it as a medicine. Type two is very different Type one.
They're not making any insulin. Type two. They're making their
(06:20):
own insulin, but there's issues with the quantity that's being
made or how the body's responding to it, and our
environment plays a big role in that is specifically what
we eat. So this study was crazy, like huge because
type one, we've been told is like you live with it,
(06:41):
you take insulin for the rest of your life, and
there's no cure.
Speaker 2 (06:45):
Like Type two is reversible in theory.
Speaker 1 (06:47):
Right, yeah, very much in theory. In practical cases it
can be put into remission.
Speaker 2 (06:53):
But type one is the assumption has always been like this,
it's an autoimmune disease and you.
Speaker 1 (06:58):
Have it, yeah, and you need to be on insulin.
Speaker 2 (07:01):
So this is clearly like a huge deal. Like fourteen
people were in the study. Twelve made it to the
final stage, but ten people were cured. Essentially after one
year they no longer needed insulin, which means they were
making their own insulin. Is that right, Yeah?
Speaker 1 (07:17):
Yeah, I mean you're bringing up some interesting points, like
this is a small study. First of all, One other
quick note about this study that I just wanted to
mention I was able to get my hands on the
appendix of this original article published in the New England
Journal of Medicine looking at stem cell derived fully differentiated
(07:38):
islets for type one diabetes, so basically looking at using
stem cells for people with type one diabetes. And actually
it turns out that they enrolled initially twenty three people
and started them on the immunosuppressive therapy, but they actually
ended up dosing twenty two people in total, fourteen which
(08:01):
the main paper states the catches that they were only
able to follow fourteen people for more than a year
out so why the other eight individuals were lost to
follow up isn't clear. It wasn't mentioned in the study,
So I am curious, you know, did they have side
effects and just quit or what exactly happened. Of course,
(08:22):
there could be a lot of reasons why people fell
out of the study, because that happens in research, right
like people move, they have life issues. The bottom line
is that you know, again this is a very small
sample size, but it is it is a little bit
interesting this extra information. But yes, to be clear, eventually
there were people that were initially insulin dependent type one
(08:46):
people with diabetes now requiring zero insulin, they were making
their own insulin.
Speaker 2 (08:52):
How does this treatment work?
Speaker 1 (08:53):
Okay, so this is it's wild because what the researchers
did is they used stem cells, which essentially they grew
these stem cells in a lab and they turned them
into the pancreatic islet cells.
Speaker 2 (09:08):
How do you know how they do that? How do
you do that?
Speaker 1 (09:10):
Well? So all stem cells are are they're special cells
that can grow into other types of cells. And this
technology has been around for a while before studies like
in humans. They were doing this on rats, so I'm
sure it took a lot of rats for them to
figure out the right kind of cells. But at some
point along the way they figured out, okay, we can
(09:31):
grow pancreatic cells in the lab. Then they gave the
patients the pancreatic cells. They infuse them through the portal vein,
which carries blood to the liver. So they had these
ports put in them and they had infusions done, and
then once they were put in their body, they just
(09:52):
gave these pancreatic cells time to just settle in and
start making insulin. What's really important about this study is
that because remember type one is an autoimmune disease, so
the body attacks the pancreatic cells. These patients were given
medicines to suppress their immune systems so that these new
(10:13):
cells wouldn't be destroyed. And they sort of hoped that, Okay,
we're going to transplant these lab cells and hope and
suppress their immune system and hope that these people their
body can make the insulin or at least require less
insulin because they can make their own.
Speaker 2 (10:31):
Doesn't that make them incredibly vulnerable to other sicknesses and disease.
Speaker 1 (10:36):
That's exactly it. So they were immuno suppressed, right, and
the most common majority of the participants, around seventy percent
of them, mostly had diarrhea and headache some of them.
Three of those participants, their blood counts dropped really really low.
It's called neutropenia, and they were hospitalized where they needed
(10:58):
to be observed. There were two participants that died, but
the study, the people that wrote the paper said like,
they don't think it's related to the immunosuppression that they
were given, because, Okay, the two people that died, one
person died of meningitis and specifically they got Cryptococcus meningitis,
(11:18):
which happens in people who are immunocompromised. But they're saying
that actually a year and a half after they got
their infusion, this person had sinus surgery and there were
complications of the sinus surgery and they were on high
dose immunosuppressants for a long period of time because of
that surgery, and that's how they got meningitis, because the
sinus got compromised and then something went into the brain
(11:41):
and then the person died. The second person who died
in the study actually had severe dementia. And this person
had a traumatic brain injury from a car accident from
a time that they had hypoglycemia when they were having
Type one. So unfortunately that person died because they developed dementia,
(12:04):
which was just like a progressive complication. They don't think
it's related to getting immuno suppressed.
Speaker 2 (12:10):
God, that must have been like so awful for the researchers.
Like two people died and they have to explain it away.
Speaker 1 (12:16):
I mean that's research, right, Like that's right, that's like
the whole point.
Speaker 2 (12:20):
Of they didn't die because of us. We didn't do
it reptelling you.
Speaker 1 (12:24):
I mean, I think not though, is this study was
funded by the pharmaceutical company that makes the medicine that
makes the stem cells, so like they obviously have an
incentive to putting their best face forward. And the bottom
line is, I think we need like a much larger study.
We need to study this in a bigger population. I mean,
(12:47):
it's very promising. They ended up proving that these individuals
were making their own insulin, which is incredible, Like they
scientifically proved that because at the beginning of the study
they checked a blood value in these people called sea peptide,
and seapeptide is a blood test you can order. It's
a precursor for insulin, So you can check a sea
(13:09):
peptide level on someone and determine are they making their
own insulin. At the beginning of the study, these people
had sea peptide levels that were undetectable, and at the
end of the study they had sea peptide levels that
were highly detectable, which indicates that they began producing their
own insulin.
Speaker 2 (13:29):
Amazing. Yeah, how common is type one diabetes? And like,
what are the implications of this? Like, now that this
research has happened, where are the next steps? Does a
drug get mass produced? What happens from here.
Speaker 1 (13:42):
I think it's still way too early to start the
mass production. We don't know how much this would cost
the average person. Type one diabetes affects over eight million
people around the world, so it's a it's a small number,
but it's still significant. The other to remember about this study,
which I think is really interesting, they pre selected people
(14:06):
who had at least two hypoglycemic episodes in the previous year,
So these are people with type one where they were
having hypoglycemic complications. Not everyone that has type one will
have a hypoglycemic episode, so they pre selected like the
more difficult population, and I think we just need more time.
(14:27):
I think this is very exciting. This is like a
big deal. I think though, we need to do bigger studies.
And also it would be nice if we had another
study that was funded by not the pharmaceutical company that
is interested in making this work. If we can have
(14:48):
a different kind of study and then really look at
it very objectively, I think that would be very interesting.
Speaker 2 (14:53):
So whenever, like pharmaceutical companies do studies, like, are they dubious?
Speaker 1 (14:59):
Not always?
Speaker 2 (15:00):
It is not always.
Speaker 1 (15:01):
I think it's just important to follow the money, like
who has an incentive in making this work right, right, right, right.
So that being said, I think this is super cool.
I think it's super promising. And if someone would Type
one is listening, I would love to hear what you think,
you know, because you're the one living with this.
Speaker 2 (15:20):
Is this potentially the end of diabetes?
Speaker 1 (15:23):
I think it's definitely a promising start, right, but more
to come.
Speaker 2 (15:30):
This is healthstone. Right after this break, we'll be back
with some more. So I'm gonna shift the conversation a
little bit because we've been talking about type one diabetes.
Let's go to type two diabetes. Yeah, And this article
is for obvious reasons. It's it's very special to both
of us because when people think of Indian people, there's
(15:52):
two things that obviously come to mind, diabetes and mangoes.
I doubt that's the case where people are looking at us.
I'm like diabetes and mangoes.
Speaker 1 (16:02):
But I can say that's what Indian people think about
when they think of India.
Speaker 2 (16:08):
Yeah, it's like diabetes and mangoes. There's conventional wisdom that
because mangoes are so sweet, people with type two diabetes
have to avoid eating them. But Indian mangoes are gods.
Ambrosia and not eating one hurts the soul.
Speaker 1 (16:25):
I mean, ain't that the truth? Man?
Speaker 2 (16:29):
So research was done in India and they studied and
compared glycemic levels of people who ate mangoes with those
who ate plain white bread, and they found that folks
who ate mangoes had a similar or lower glycemic response
to the white bread people. So I think it's this
very very good news for the world because mangoes are
the king of fruit and Indian mangoes are the king of.
Speaker 1 (16:51):
Kings, right and now with your crown on your tooth,
I mean, oh, oh, my God, like so royal. God,
I love me. I love that. I mean just I remember,
like as a kid when I would be in India, like,
just mangoes tastes sweeter there. I mean, it's so, it's
just so wonderful.
Speaker 2 (17:11):
Oh, it's hard to explain the rest of the world
that you like, your mangoes are fine, because mangoes are incredible,
But like you don't even know, you don't know, you
don't know. I was talking to Kamail Nanjiani and he
was talking about Pakistani mangoes and he was saying that
his wife tried Pakistani mangoes for the first time, like
(17:32):
he had some ship and just she couldn't talk, like
she was just absolutely floored by the incredible taste of
South Asian mango.
Speaker 1 (17:41):
Oh yeah, and you know in India there's there's literally
over a dozen varieties, so many types of mangoes, you know,
and like local pride, North Indian mangoes, South Indian mangoes.
It's yeah, I.
Speaker 2 (17:54):
Mean common with you know, people generally say that the
Alfonso mango is the greatest of all Indian magas goes,
but I think the Bengana bully has A was a
pretty good case.
Speaker 1 (18:05):
Oh my gosh. Yeah, No, this was a fun study
to look at. It actually made me laugh out loud.
Speaker 2 (18:12):
Well, there's one thing I don't understand, Prianka. Yeah, so
they compared people who ate mangoes and like white bread. Right,
so this just tells us white bread is bad for us,
because who's making the choice between mangoes and white bread?
Speaker 1 (18:27):
Exactly? Yeah, No, I completely agree. To get really granular
about the details of the study, they had people for
eight weeks. They measured out the mango two hundred and
fifty grams of mango pulp, which is equivalent to one mango.
Speaker 2 (18:44):
With this one small mango one.
Speaker 1 (18:48):
Okay, fine, that's fine, but I love this. They also
gave them two hundred milileters of amel brand milk Amol brand,
if you know, you know. That's all I'm gonna say.
And then the other group got and they measured it
out eighty one grams of white bread, the Harvest Gold
(19:09):
white bread. It's like they named the brand, which is
it's equal to about two pieces of white bread with
a glass of milk, the Omolbran milk. And so the
rest of the day people ate the same exact type
of food. It was like calorie match for the rest
of the day based off of like Indian guidelines. And
then they looked at baseline like blood sugar weight, cholesterol,
(19:32):
body mass, skinfold, thickness, insulin levels, and then yeah, essentially
compared to the white bread eaters, the mango eaters had
lower blood sugar, better cholesterol, less belly fat and this
was statistically significant. So, I mean, just to me, this
is like, how much more evidence do you need that
(19:54):
processed foods are bad for you?
Speaker 2 (19:58):
I mean, say anything about the mangoes though.
Speaker 1 (20:02):
Yeah, so they actually did two different types of mangoes.
There were two different species from two different parts of
the country. So both of those mangoes outperform the white bread.
Speaker 2 (20:15):
But is it fair to say that a lot of
things would outperform the white bread?
Speaker 1 (20:20):
Oh yeah, I think yes absolutely. I mean I processed
foods are really a problem, Like we are not accepting
this enough in our society across the world. All this
study tells me is that this is a statement on
the harmful effects of white bread. That it's like literally
better teat mangoes than it is heat white bread. I
(20:41):
still think someone with type two diabetes would benefit from
a carbohydrate reduced diet because we know type two diabetes,
which is related to having high insulin levels, that's all
controlled by carbohydrate intake. So if you don't eat as
many carbohydrates, which includes sugars and processed foods, your insulin
(21:03):
demand will go down and the type two diabetes won't
be as severe.
Speaker 2 (21:08):
So how big is type two diabetes globally huge?
Speaker 1 (21:12):
It's huge. According to the International Diabetes Federation, diabetes cause
two point four million debts in twenty twenty four and
five hundred and eighty nine million adults are currently living
with diabetes worldwide, and that's expected to go up to
eight hundred and fifty three million by twenty fifty in
the United States. I mean, fifty percent of Americans are
(21:35):
pre diabetic.
Speaker 2 (21:36):
How preventable is type two extremely? Like, what would we
have to do or avoid societally to not have the
numbers that we're having.
Speaker 1 (21:48):
I think what would be very helpful is if the
government actually stops subsidizing corn, which then allows for the
creation of highly processed foods dating high fructose corn syrup.
A lot of foods that are cheap are very high
in carbohydrate and very processed, and those are the exact
(22:08):
foods that cause diabetes, right, And so I don't think
people intentionally want to eat food that makes them sick.
I think sometimes economically they're forced to not really have
a choice. And so the first thing we need to
do is shift the economics around what people can afford
so that they are eating more nutritious food that's unprocessed
(22:33):
and doesn't raise their insulin levels. But in my private practice,
Just and I have taught this course at UCSF for
many years, helping people have type two diabetes put their
diabetes in remission using low carb diets which really work.
Like I have personally had patients who were on insulin
(22:54):
because of type two diabetes that they were able to
get off of insulin with just carbohydrate reduction.
Speaker 2 (23:01):
Wow.
Speaker 1 (23:02):
And that's not like, you know, no prescription, like it's diet, right.
So I really believed so much of type two diabetes
is because of what's going on environmentally. And I do
think that we could make massive legislative, economic, environmental changes
that could change the health of our country for sure.
Speaker 2 (23:24):
So what's the story with this harvest gold bread? Is
it different than other kinds of white bread? Is it
any worse or so.
Speaker 1 (23:32):
Harvest gold white bread is? I mean, it's super processed.
I actually found the ingredient list from the actual label.
Number one ingredient refined wheat flour. Sixty four percent of
that is you know, good real bread should just have
flour and water and that's it. Second ingredient is sugar,
(23:55):
So they add sugar, yeah, then followed by yeast, salt, lutin,
and then they just put preservatives number two eighty two
and two hundred. God only knows what that is.
Speaker 2 (24:06):
God not to eighty two, not to eighty two.
Speaker 1 (24:13):
Then it goes on. They add soilflour, which is highly
processed and then edible vegetable oil, which is a combination.
They put parentheses soy oil, soybean oil and palm oil,
very highly processed oils, very inflammatory. Next ingredient emulsifiers number
four eighty one, four seventy two, four fifteen geez, followed
(24:35):
by acidity regulators two seventy and two ninety seven, antioxidant
number three hundred, and then a flower treatment agent number
five nineteen. So as you can see, this is loaded
with chemicals.
Speaker 2 (24:49):
Whenever there's a number next to the ingredient, that's like
really bad.
Speaker 1 (24:53):
There's nothing like good old organic flower treatment agent number
five sixteen. It just like Grandma used to make it. So,
I mean, the key here is that when we eat
such highly processed foods, you compare that to a mango,
which is a starch, It RECs havoc on the body.
(25:14):
It causes inflammation, and inflammation raises glucose levels and insulin
levels and all sorts of other health issues. So I'm
not surprised there's so much data already out there saying
process foods are bad, But like this study kind of
puts in your face, like please, you know, right after
this break, we'll be back with more. So, how do
(25:40):
you something I want to get your take on.
Speaker 2 (25:43):
Is this about baseball?
Speaker 1 (25:44):
No? No, But I don't know if you know, but
there's actually a fierce price battle happening between Novo Nordisk,
the company that makes ozembic with the GLP medications, or
as Trump called it, the fat shot, Oh God, and
(26:06):
compounding pharmacies, which are these type of pharmacies that make
customized drugs. A lot of them are online, and sometimes
folks go to them to get these golps for cheaper.
Speaker 2 (26:18):
I've been aware of this price battle for about five
minutes when I read the intro to the show, but
other than that, no, I have no idea. Yeah.
Speaker 1 (26:27):
Yeah, so it's a battle to see who can corner
the market. And Nova Nordisk has teamed up with this
website called good Rx. I don't know if you've heard
of it, but yeah, so it's like this expedia for
pharmaceutical drugs, and they have slashed the price of a
zempig and a gov basically in half. But obviously there's
(26:49):
a catch, right, This price is only for people who
will pay straight up cash, meaning they won't go through
their insurance.
Speaker 2 (26:58):
Yeah, system's broken. That's what is the point of insurance?
If I could just pay cash to get the drug
for cheaper, what is the point of.
Speaker 1 (27:07):
That you can buy these medications for four hundred and
ninety nine dollars instead of what is typically one thousand
dollars if you don't have insurance, right, I mean, for me,
it's like, okay, if they're dropping the prices now, it's
like what were they doing the whole time when the
prices were so high?
Speaker 2 (27:26):
You know what I mean.
Speaker 1 (27:27):
I've had multiple patients who have sought out golp ones
and we're told by the insurance like, okay, well, if
you if you get it through your insurance, it'll cost you,
let's say, three hundred dollars a month plus whatever it
is you got to meet your deductible right, which they're
(27:48):
already paying into. But then they will they'll go to
the manufacturer and be told, oh, well, if you're going
to pay us directly, it's just going to cost you
two hundred dollars a month straight.
Speaker 2 (28:01):
Wow. Yeah.
Speaker 1 (28:02):
Multiple cases of this, so it's like they have no
incentive to go through their insurance, right, And it's I mean,
this is such proof of just how messed up our
insurance system is right now, right Like we were told like, oh,
this is a system we're creating, this health insurance system.
It's originally designed we're going to lower costs for everyone
because we're going to spread costs over a larger pool
(28:25):
of people. But the reality is this is just a
transfer of our taxpayer dollars to corporations that are for profit,
have some of the highest profit margins. They're some of
the most profitable companies on the stark market. They're driving
the SMP.
Speaker 2 (28:40):
Why are they lowering the prices right now? Is it
because the demand is so high and people insurance is
not covering it or making it affordable enough, so they're
just like, okay, then we'll sell it ourselves. Like why
are they doing this right now?
Speaker 1 (28:53):
When you hear from them, they'll say things like, oh,
we are interested in capturing the individuals that don't have
health insurance and we want to make sure that they
get the coverage. You know. It's like, oh God, jag
me alrighty, like give me a break, like corporate mumbo jumbo.
(29:14):
I mean I want to say, like four ninety nine
is not like a consumer friendly price, that's like the
that's an infomercial price. Yeah, you know, like anything that's
costs four ninety nine, it's.
Speaker 2 (29:27):
Not an infomercial price because they would give you one
free along with it. If you order right now, you'd
get a second one for free. I know Bernie Sanders
described the announcement as a modest stepped forward, because that's
what Bernie would say. He's going to be like, this
is great. It's gonna be like this is because it
is a modest step. This is a quote Novo noticed.
(29:50):
The move to cut the price of a zempic to
four hundred and ninety nine dollars for the uninsured is
a modest step forward. But let's not forget ozempic costs
just fifty nine dollars in Germany, while it costs less
than five dollars to make. The US must no longer
pay the highest prices in the world for prescription drugs.
Which the biggest thing that Bernie says that would lower
(30:13):
the prices is to expand Medicaid exactly.
Speaker 1 (30:16):
I mean, clearly, for profit health insurance systems are not working,
and what we do need is a medicare for all
everyone covers everyone that is not for profit does not
have huge margins and is just intended to give people
access to care and medications that they need.
Speaker 2 (30:37):
Yeah, so drug companies are saying they're lowering prices to
compete with compound pharmacies. And this was new to me
because I'd never heard of a compound pharmacy before. But
if you've seen the ads for a startup selling low
priced versions of glps all over the internet, well, that's
a compound pharmacy. So I'm wondering, are these drugs just
to save.
Speaker 1 (30:58):
So it depends like certain like there have been some
cases where people getting it from compounding pharmacies. There's been
some adulteration. It's not pure. If you get a brandname medication,
then you know you're getting one hundred percent of that
medication down to like a very very small degree. So
(31:19):
there have been a couple of situations where people had
some untoward side effects.
Speaker 2 (31:23):
So explain compound pharmacies to me a bit more, Like,
I know they customized drugs, but why are they also
useful for physicians.
Speaker 1 (31:32):
It's a legally operating pharmacy that requires prescriptions, but they
can make doses of medications that aren't part of the
standard regimen that you would get at like a major pharmacy.
So let's say I needed a medication and I'm just
making it up. Ten milligrams was the lowest dose that's prescribed,
(31:53):
but I, for my body only wanted five milligrams. I
could go to a compounding pharmacy and they could make
it unique to whatever my needs were.
Speaker 2 (32:03):
Couldn't you also just cut the pill in hand?
Speaker 1 (32:05):
I mean, yeah, you can also just got the thing up.
But I mean that's just my example.
Speaker 2 (32:18):
Health Stuff is a production of iHeart podcasts. Don't forget
to send us your voice memos with all those pesky
health questions that keep you up at night. Email us
at health stuff podcast at gmail dot com and go
and subscribe to health Stuff wherever you get your podcasts.
Talk to you soon.
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