Yale Expert Addresses Diabetes Crisis at Senate Committee Hearing

Kasia Lipska, MD, MHS, associate professor of medicine (endocrinology and metabolism), was one of five experts invited to testify at the Senate Health, Education, Labor, and Pensions (HELP) Committee hearing on December 14, 2023. Titled “What is Fueling the Diabetes Epidemic?,” the hearing explored the reasons behind the increase in type 2 diabetes in the U.S., the impact of the epidemic on the health care system, and ways to make treatments available to everyone, regardless of income.

Diabetes, a condition in which the body does not produce insulin or does not use insulin properly, affects over 38 million people in the U.S. Research shows that having obesity is a major risk factor for developing type 2 diabetes.

Currently, over 40 percent of adults in the U.S. have obesity, according to the 2023 State of Obesity report. During the last two decades, the national obesity rate for adults has increased by 37 percent; the rate of youth obesity has increased by 42 percent, the report said.

About 80 to 90 percent of people with type 2 diabetes are overweight or have obesity, and the continued rise in obesity is driving diabetes, Lipska explained.

Lipska’s research focuses on the safety and effectiveness of medications that treat type 2 diabetes. At the hearing, she shared stories and data from her experiences as a clinician to highlight the barriers her patients face in accessing treatment. “Effective new therapies for obesity that are also approved for diabetes, like Ozempic or Mounjaro, help people lose weight and reduce the risk of complications associated with diabetes and obesity, but they are outrageously priced,” she said. “We have a responsibility to make them accessible to people who need them.”

To make these medications affordable, Lipska recommended implementing price negotiations between the government and pharmaceutical companies and aligning the launch price of the medicine with the cost to develop and manufacture the drug. She pointed to Sweden, Australia, and France, where Ozempic is available at a fraction of U.S. cost.

Lipska also stressed the importance of addressing some of the underlying factors that have contributed to the diabetes and obesity epidemics. “Our genetics have not changed over the past twenty years,” Lipska said. “What has changed is our environment, and it is a big contributor.”

Lipska pointed to the food environment as a significant contributor to diabetes and obesity in the U.S. “For example, the food industry advertises unhealthy foods to children and promotes products that are metabolically toxic yet very palatable and addictive,” she said.

The new medicines are part of the solution, she added, but they are also feeding a cycle. “As a society, we are investing an exorbitant amount of money in these new anti-obesity drugs, and, as a result, that money may no longer be available to address the key drivers of this crisis in the first place,” she said.

Lipska found serving as a witness at the HELP Committee meeting to be a powerful experience; through her testimony, she hopes to bring about change.

“It was a privilege, as a physician, to voice the issues that my patients face and to ask Congress to help them,” she said.

To view a recording of the hearing, go to “What is Fueling the Diabetes Epidemic?”

Yale School of Medicine’s Section of Endocrinology and Metabolism works to improve the health of individuals with endocrine and metabolic diseases by advancing scientific knowledge; applying new information to patient care; and training the next generation of physicians and scientists to become leaders in the field. To learn more, visit Endocrinology and Metabolism.