Questions are being raised about the case of a 36-year-old Ontario woman who died of liver failure after she was rejected for a life-saving liver transplant after a medical review highlighted her prior alcohol use.
A partial liver transplant wasn’t viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor, or she would die in operation.
Since she wasn’t eligible, a partial transplant was just a death sentence.
Liver failure is terminal. She was invariably going to die without the transplant. She wanted to receive the donation, her donor wanted to donate. If the success rate for a living transplant is zero that’s one thing, but that’s not being claimed here since she wasn’t eligible for procedural reasons.
They said it was viable in the early stages, and with a decent success rate. Just not the success rate they wanted, and for some daft reasons you need to be eligible for a full transplant from a dead patient to get a partial transplant from a living donor. Makes no sense.
No. A partial liver transplant wasn’t viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor. But she wasn’t eligible, so a partial transplant was just a death sentence.
It’s not like giving away part of your liver is a zero sum game, now that person is at risk of infection, has lesser liver performance, and for what? Someone who has showed they will just continue to harm themselves, and others (the person they’re getting the liver from,) if you allow it?
I don’t know any other surgeons who would do that.
If a surgeon refused to let me save the life of the one person in the world i love then they wouldn’t be able to save any more lives after that so add that to your heartless calculations…
There are very few transplant surgeons who would take the risk of a partial liver transplant which they have high likelihood of being a death sentence for the patient (not sure if you read but they need a full liver, from a cadaver, not partial,) and want to willingly throw their name in with another patient to discuss during M&M.
This is coming directly from familiarity with the procedure, comorbidities, and other factors from a general surgeon at a top 10 hospital in the US.
Has lesser liver performance? What? Do you understand how a living transplant works? You both regrow a full liver after the procedure, because livers are so regenerative you can make a full one from less than half. This makes no sense to me.
Also she quit for 5 months after she found out she had liver failure.
It takes years for a donor’s remaining liver to grow back, and the recipient is unlikely to grow out more of the donated liver depending on comorbidities and severity of illness.
I’d have supported her paying out of pocket to use the live donor that was willing, but not to use my tax money when it’s pretty fucking clear she has no intention of changing.
It’s the same reason I’m largely against the Liberal’s diabetes funding - ~90% of diabetics are Type 2 (I’m willing to help Type 1’s out because it’s not their fault) and the vast, vast majority of those are from unhealthy lifestyle even if they are genetically predisposed.
If were going to have a public health system, people should be required to take care of themselves. And no, I’m not talking about the one-off accidents from riskier activities (although I do think people should bear the cost of their own healthcare if it’s the result of criminal activities), I’m taking the problems that occur as a result of abusing your body for years or decades.
You’ve gotten a lot of downvotes but rather than doing that I want to explain to you why your position here is flawed.
First think of every lifestyle activity whether it be food, motorcycle riding, music, etc. Now consider that there are some activities that are statistically safer than others.
If we took your position to the point of being law why would we stop at food lifestyle choices? Why not just any risky lifestyle choices? Eventually you end up with a society where individuals have less choice and freedom and are constantly obligated to live the safest possible lives.
You and I both know that isn’t a desirable outcome. We should be empowering people to live the lives they choose and encouraging them to be healthy, not punishing them for make the “wrong” choice.
I attempted to address this but perhaps I wasn’t clear:
Yes, some activities are risky then others, however many of them have absolutely 0 negative impact on you unless something major happens all at once. In fact, many of them have major health benefits for the vast, vast majority of participants.
Contrast the above to overeating, chronically eating stuff that’s not good for you (ex. excessive sugar, salt), drinking too much, doing lots of drugs, smoking… that kind of behaviour will basically screw up everyone who partakes given enough time and has no positive health benefits at all.
You talk about a loss of freedom… I’ve already lost freedom by paying for a bunch of people who purposely fuck themselves up for no tangible benefit to themselves. There is stuff that would be good for me that I literally can’t afford because of the amount of taxes I pay.
Here’s an idea for your route of encouraging healthy lifestyle rather than removing freedom: include a physician form in my taxes where my doctor attests that I am generally in good shape (given my age) and he has no reason to believe I am doing anything that is a risk factor for chronic cardiovascular or lung diseases, diabetes or related chronic illnesses, and give me a significant tax break for doing so.
Consider what you just said can apply to motorcycling or buying a classic car with outdated safety features. There is no tangible health benefit to motorcycling or driving a classic car, it basically “has no positive health benefits at all” (as per your own words) and only increases risk. Show it be banned? What about every other risky hobby? If not, then neither should eating junk food which is measurably less dangerous/risky. Keep in mind that for smoking the overall trends of diminishing smoking habits in younger generations basically highlights the proof that encouraging healthy habits rather than punishing the individual is the correct way to approach this.
Buying a motorcycle or classic car doesn’t necessarily lead to injury in the same way that overeating and being lazy to the point of becoming a land whale does.
Being a judgmental asshole increases your likelihood of being assaulted. I shouldn’t have to pay your medical bills when you get punched in the face by a stranger.
I suggest you look up just how often motorcycle injuries/deaths happen. What you’re saying only applies if you never get into an accident or fall off the bike ever, in the entire period it is owned (which could be 20-30 years). Something which is incredibly unlikely. From the language you’re using (i.e whale) I’m getting the impression that your position isn’t rational and instead based on a dislike of overweight people. I’ve done what I can here but I don’t think you’re messaging back in good faith and don’t want to entertain the perspective of someone who tries to put others beneath them based on their body and eating habits.
I’d be willing to bet that the number proportion of motorcycle owners with health problems caused by riding is a hell of a lot lower than the proportion of people who don’t eat right and don’t exercise enough and have health problems linked to that.
And no, it’s not just overweight people I don’t like, it’s also people that are sick all the time (like, weak immune coughs and colds type of stuff).
I think if you seriously hold those views you should consider the fact that there are many reprehensible individuals which thought exactly like you do in the past. Though the groups they chose and the reasoning provided varied, all being equally irrational, they found reasons to neglect if not outright try to erase individuals which they perceived as somehow inferior to themselves because of their lifestyle choices. They falsely thought, like you do, that society would be better off if these individuals were not part of it and “punished” for their lifestyle choices.
This is a point where you need to actually realize for yourself what you’re arguing for is reflective of a worldview which is objectively evil. You need only to look up the horrors of eugenics, of every ethnic genocide, of every society which chose to discriminate rather than uplift its members.
From the way you speak you seem to think that those who are strong or smart or talented have no duty to anyone but themselves. But you fail to realize that one day you may get sick, one day you may be old, one day you may be involved in an accident through no fault of your own, or by means of your lifestyle choices. At that time, you will need people to care for you, and you will realize exactly what I’m trying to tell you here.
For reference, the way you think is not new. I suggest you look through the chapter in Plato’s republic where Socrates speaks with Thrasymachus about how “might does not equal right” to gain perspective on this. Thrasymachus held your worldview. It was one of the first positions that Socrates showed to be indefensible.
Who says how much it’s acceptable to eat or drink?
I don’t care if you’ve gotten enough exercise, you would be healthier if you were walking around the block right now instead of sitting inside on the internet. Since my taxes pay for your medical bills I get to tell you how to live your life, so get walking!
If were going to have a public health system, people should be required to take care of themselves
On the face of it, this sounds sensible. But, thinking more deeply, who should decide the required amount of care a person ought to take? Ideas about what it means to ‘take care of yourself’ are varied. And consider that some citizens of this country are simply unable to take the same personal health decisions that others have the privilege to take without a second thought.
What you’re talking about here isn’t a public system. A healthcare system that only serves certain chosen people is not public in any meaningful sense.
A public healthcare system is imperfect on the whole, but on average, when funded and administered properly, is structured to apportion care based on need, instead of the profit motive. I think that’s worthwhile, and the right thing for a society to do from a moral standpoint.
So I drink more pop than I should. Why should I have to pay more for my healthcare than my buddy who had a habit of timing running green lights as soon as they turned green. That isn’t illegal, either, yet it’s very risky behavior. It didn’t work out for him just one time, and he nearly died. Why should taxpayers have to pay for him?
The answer is because the vast majority of us engage in risky behavior, or just have the bad taste of passing on our poor genetics to the next generation, and the social cost for penalizing people for not agreeing with societal norms are too high. This includes drug use, even legal ones like alcohol. Sure, don’t spend limited resources such as donated livers on people who aren’t willing to make the lifestyle changes required to make it worthwhile, because someone else will probably have to die for that to happen. But if we could make new livers and the price was reasonable, I wouldn’t even be against that.
If your buddy who likes gambling with green lights was convicted of a traffic offence as part of that accident he should have been on the hook for his own healthcare and the healthcare of anyone else he hurt.
Way to miss the point. It’s a good thing you don’t engage in any risky behavior, or anything that would have a negative impact on your health. I mean, it’s not like you would be a hypocrite, right?
I never said “Don’t engage in any risky behaviour”. Stuff like cardiovascular and lung diseases and Type 2 Diabetes doesn’t happen over the course of days, weeks, or months, you have to be chronically treating yourself like crap for years to get to those points.
oh, sorry, there was much talk about public health insurance, i Of course don’t have a clue how that works in canada. sorry, my fault. I only focused on public health care, here in germany thats an insurance, i was ignorant.
Not a problem. It’s essentially rolled into our taxes for the most part in Canada. You may have health insurance on top of that, but that isn’t a guarantee and usually is a top-up of our universal coverage. This usually covers things like drug prescriptions, glasses, and hospital conveniences such as semi-private or private rooms. I agree with the general idea, though, that we as a group pay for everyone who is covered. My original point at the top of this thread is that removing people’s eligibility simply because of risky behavior can be very tricky and likely harmful to society.
no alchol consumption is safe, so using your line of thinking you’d need to argue that anyone who partakes of alcohol at any anytime would fall under that line of thinking
Processed red meats simailary, especially those treated with nitrites, so those eating bacon, ham etc shouldn’t be entitled to public heath care under your reasoning
On the upside, now you’ve excluded 95% of the population, public healthcare will be cheap :)
Contra to most peoples thinking, if you’re concerned about public healthcare costs, you should “encourage” obesiety and smoking, they all die early, most health care coats are associated with healthy people in their old age. See here
it does not cost the state A DIME, because it is insurance that covers healthcare, not taxes.
The loss is unrealized potential of those who are sick. so, that means the state invested like 150.000 bucks in one citizen, in hopes to get like one million bucks out of them
(not out of them specifically, but out of their labour; it is a chain, you see, and the labourer pays taxes, the factory pays taxes when selling the product, the consumer pays taxes when buying the product, and so on)
alcohol and obesity by diabetis harm EVERY cell in your body, period. thats hard biochemstry, facts, it is the truth.
red meat, on the other hand, is quite unclear.
the studies involving red meat are interesting;
people self report by remembering long periods of time, a salami pizza counts as red meat, as does a whole mc donalds burger with fries on the side.
as for nitrate, this gets complicating. you seem to be on the right path. nitrates are a new topic for me, i never before read up on them:
Until there is a diet that has long term success for a majority of its users I don’t think this mindset is healthy or realistic.
“According to the latest weight-loss research, 95% of dieters end up regaining the weight they lost within two years. Calorie-restricting diets are often successful at helping people lose weight, but they’re very unsuccessful at helping people maintain that weight loss.” source
Type 2 diabetes has a stronger link to family history and lineage than type 1, and studies of twins have shown that genetics play a very strong role in the development of type 2 diabetes.
Now that you know you were cruel and wrong about diabetes, what do you have to say? What about the type 2 diabetics that have a perfect lifestyle and still have type 2 diabetes?
As an alcoholic, I initially agreed. Don’t waste a liver on me. Then this:
What the actual fuck.
A partial liver transplant wasn’t viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor, or she would die in operation.
Since she wasn’t eligible, a partial transplant was just a death sentence.
Liver failure is terminal. She was invariably going to die without the transplant. She wanted to receive the donation, her donor wanted to donate. If the success rate for a living transplant is zero that’s one thing, but that’s not being claimed here since she wasn’t eligible for procedural reasons.
They said it was viable in the early stages, and with a decent success rate. Just not the success rate they wanted, and for some daft reasons you need to be eligible for a full transplant from a dead patient to get a partial transplant from a living donor. Makes no sense.
Takes up valuable hospital times
No. A partial liver transplant wasn’t viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor. But she wasn’t eligible, so a partial transplant was just a death sentence.
It’s not like giving away part of your liver is a zero sum game, now that person is at risk of infection, has lesser liver performance, and for what? Someone who has showed they will just continue to harm themselves, and others (the person they’re getting the liver from,) if you allow it?
I don’t know any other surgeons who would do that.
If a surgeon refused to let me save the life of the one person in the world i love then they wouldn’t be able to save any more lives after that so add that to your heartless calculations…
Yes these people should indeed be killed for letting another human die for no good reason.
There are very few transplant surgeons who would take the risk of a partial liver transplant which they have high likelihood of being a death sentence for the patient (not sure if you read but they need a full liver, from a cadaver, not partial,) and want to willingly throw their name in with another patient to discuss during M&M.
This is coming directly from familiarity with the procedure, comorbidities, and other factors from a general surgeon at a top 10 hospital in the US.
Has lesser liver performance? What? Do you understand how a living transplant works? You both regrow a full liver after the procedure, because livers are so regenerative you can make a full one from less than half. This makes no sense to me.
Also she quit for 5 months after she found out she had liver failure.
It takes years for a donor’s remaining liver to grow back, and the recipient is unlikely to grow out more of the donated liver depending on comorbidities and severity of illness.
I’d have supported her paying out of pocket to use the live donor that was willing, but not to use my tax money when it’s pretty fucking clear she has no intention of changing.
It’s the same reason I’m largely against the Liberal’s diabetes funding - ~90% of diabetics are Type 2 (I’m willing to help Type 1’s out because it’s not their fault) and the vast, vast majority of those are from unhealthy lifestyle even if they are genetically predisposed.
If were going to have a public health system, people should be required to take care of themselves. And no, I’m not talking about the one-off accidents from riskier activities (although I do think people should bear the cost of their own healthcare if it’s the result of criminal activities), I’m taking the problems that occur as a result of abusing your body for years or decades.
You’ve gotten a lot of downvotes but rather than doing that I want to explain to you why your position here is flawed.
First think of every lifestyle activity whether it be food, motorcycle riding, music, etc. Now consider that there are some activities that are statistically safer than others.
If we took your position to the point of being law why would we stop at food lifestyle choices? Why not just any risky lifestyle choices? Eventually you end up with a society where individuals have less choice and freedom and are constantly obligated to live the safest possible lives.
You and I both know that isn’t a desirable outcome. We should be empowering people to live the lives they choose and encouraging them to be healthy, not punishing them for make the “wrong” choice.
I attempted to address this but perhaps I wasn’t clear:
Yes, some activities are risky then others, however many of them have absolutely 0 negative impact on you unless something major happens all at once. In fact, many of them have major health benefits for the vast, vast majority of participants.
Contrast the above to overeating, chronically eating stuff that’s not good for you (ex. excessive sugar, salt), drinking too much, doing lots of drugs, smoking… that kind of behaviour will basically screw up everyone who partakes given enough time and has no positive health benefits at all.
You talk about a loss of freedom… I’ve already lost freedom by paying for a bunch of people who purposely fuck themselves up for no tangible benefit to themselves. There is stuff that would be good for me that I literally can’t afford because of the amount of taxes I pay.
Here’s an idea for your route of encouraging healthy lifestyle rather than removing freedom: include a physician form in my taxes where my doctor attests that I am generally in good shape (given my age) and he has no reason to believe I am doing anything that is a risk factor for chronic cardiovascular or lung diseases, diabetes or related chronic illnesses, and give me a significant tax break for doing so.
Consider what you just said can apply to motorcycling or buying a classic car with outdated safety features. There is no tangible health benefit to motorcycling or driving a classic car, it basically “has no positive health benefits at all” (as per your own words) and only increases risk. Show it be banned? What about every other risky hobby? If not, then neither should eating junk food which is measurably less dangerous/risky. Keep in mind that for smoking the overall trends of diminishing smoking habits in younger generations basically highlights the proof that encouraging healthy habits rather than punishing the individual is the correct way to approach this.
Buying a motorcycle or classic car doesn’t necessarily lead to injury in the same way that overeating and being lazy to the point of becoming a land whale does.
Being a judgmental asshole increases your likelihood of being assaulted. I shouldn’t have to pay your medical bills when you get punched in the face by a stranger.
Free expression bud, it’s my right to be a judgemental asshole. Take that up with Pierre Trudeau.
And I’m free to eat a bag of chips whenever I want.
I suggest you look up just how often motorcycle injuries/deaths happen. What you’re saying only applies if you never get into an accident or fall off the bike ever, in the entire period it is owned (which could be 20-30 years). Something which is incredibly unlikely. From the language you’re using (i.e whale) I’m getting the impression that your position isn’t rational and instead based on a dislike of overweight people. I’ve done what I can here but I don’t think you’re messaging back in good faith and don’t want to entertain the perspective of someone who tries to put others beneath them based on their body and eating habits.
I’d be willing to bet that the number proportion of motorcycle owners with health problems caused by riding is a hell of a lot lower than the proportion of people who don’t eat right and don’t exercise enough and have health problems linked to that.
And no, it’s not just overweight people I don’t like, it’s also people that are sick all the time (like, weak immune coughs and colds type of stuff).
I think if you seriously hold those views you should consider the fact that there are many reprehensible individuals which thought exactly like you do in the past. Though the groups they chose and the reasoning provided varied, all being equally irrational, they found reasons to neglect if not outright try to erase individuals which they perceived as somehow inferior to themselves because of their lifestyle choices. They falsely thought, like you do, that society would be better off if these individuals were not part of it and “punished” for their lifestyle choices.
This is a point where you need to actually realize for yourself what you’re arguing for is reflective of a worldview which is objectively evil. You need only to look up the horrors of eugenics, of every ethnic genocide, of every society which chose to discriminate rather than uplift its members.
From the way you speak you seem to think that those who are strong or smart or talented have no duty to anyone but themselves. But you fail to realize that one day you may get sick, one day you may be old, one day you may be involved in an accident through no fault of your own, or by means of your lifestyle choices. At that time, you will need people to care for you, and you will realize exactly what I’m trying to tell you here.
For reference, the way you think is not new. I suggest you look through the chapter in Plato’s republic where Socrates speaks with Thrasymachus about how “might does not equal right” to gain perspective on this. Thrasymachus held your worldview. It was one of the first positions that Socrates showed to be indefensible.
Right now you’re on the internet instead of being physically active, that’s a health risk.
Who says I haven’t already gotten enough exercise today?
You’re aware of the concept of overworking your body, right?
Who says how much it’s acceptable to eat or drink?
I don’t care if you’ve gotten enough exercise, you would be healthier if you were walking around the block right now instead of sitting inside on the internet. Since my taxes pay for your medical bills I get to tell you how to live your life, so get walking!
come on guys, step over your ego.
Great, so maybe you can stop paying for my healthcare and I can stop paying for yours.
Move to the states, let me know how that goes for you.
What a shitty attitude.
On the face of it, this sounds sensible. But, thinking more deeply, who should decide the required amount of care a person ought to take? Ideas about what it means to ‘take care of yourself’ are varied. And consider that some citizens of this country are simply unable to take the same personal health decisions that others have the privilege to take without a second thought.
What you’re talking about here isn’t a public system. A healthcare system that only serves certain chosen people is not public in any meaningful sense.
A public healthcare system is imperfect on the whole, but on average, when funded and administered properly, is structured to apportion care based on need, instead of the profit motive. I think that’s worthwhile, and the right thing for a society to do from a moral standpoint.
no one bothers that it is THE PEOPLE that pay for their health insurance, not the state.
the state made insurance mandatory, thats the only thing it is guilty of.
So I drink more pop than I should. Why should I have to pay more for my healthcare than my buddy who had a habit of timing running green lights as soon as they turned green. That isn’t illegal, either, yet it’s very risky behavior. It didn’t work out for him just one time, and he nearly died. Why should taxpayers have to pay for him?
The answer is because the vast majority of us engage in risky behavior, or just have the bad taste of passing on our poor genetics to the next generation, and the social cost for penalizing people for not agreeing with societal norms are too high. This includes drug use, even legal ones like alcohol. Sure, don’t spend limited resources such as donated livers on people who aren’t willing to make the lifestyle changes required to make it worthwhile, because someone else will probably have to die for that to happen. But if we could make new livers and the price was reasonable, I wouldn’t even be against that.
If your buddy who likes gambling with green lights was convicted of a traffic offence as part of that accident he should have been on the hook for his own healthcare and the healthcare of anyone else he hurt.
Way to miss the point. It’s a good thing you don’t engage in any risky behavior, or anything that would have a negative impact on your health. I mean, it’s not like you would be a hypocrite, right?
I never said “Don’t engage in any risky behaviour”. Stuff like cardiovascular and lung diseases and Type 2 Diabetes doesn’t happen over the course of days, weeks, or months, you have to be chronically treating yourself like crap for years to get to those points.
Free climbers don’t usually die the first time, either.
You should pay for their healthcare, because you have a contract with an insurance company.
What makes you think that I, posting in a Canadian community about a Canadian article, have a contract with a healthcare insurance company?
oh, sorry, there was much talk about public health insurance, i Of course don’t have a clue how that works in canada. sorry, my fault. I only focused on public health care, here in germany thats an insurance, i was ignorant.
Not a problem. It’s essentially rolled into our taxes for the most part in Canada. You may have health insurance on top of that, but that isn’t a guarantee and usually is a top-up of our universal coverage. This usually covers things like drug prescriptions, glasses, and hospital conveniences such as semi-private or private rooms. I agree with the general idea, though, that we as a group pay for everyone who is covered. My original point at the top of this thread is that removing people’s eligibility simply because of risky behavior can be very tricky and likely harmful to society.
Thats a dark road to tread.
An example,
no alchol consumption is safe, so using your line of thinking you’d need to argue that anyone who partakes of alcohol at any anytime would fall under that line of thinking
https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health
Processed red meats simailary, especially those treated with nitrites, so those eating bacon, ham etc shouldn’t be entitled to public heath care under your reasoning
https://www.cancercouncil.com.au/1in3cancers/lifestyle-choices-and-cancer/red-meat-processed-meat-and-cancer/
Or are those things ok becase you do them ?
On the upside, now you’ve excluded 95% of the population, public healthcare will be cheap :)
Contra to most peoples thinking, if you’re concerned about public healthcare costs, you should “encourage” obesiety and smoking, they all die early, most health care coats are associated with healthy people in their old age. See here
https://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html
Adults are stupid and greedy, we all are.
it does not cost the state A DIME, because it is insurance that covers healthcare, not taxes.
The loss is unrealized potential of those who are sick. so, that means the state invested like 150.000 bucks in one citizen, in hopes to get like one million bucks out of them
(not out of them specifically, but out of their labour; it is a chain, you see, and the labourer pays taxes, the factory pays taxes when selling the product, the consumer pays taxes when buying the product, and so on)
alcohol and obesity by diabetis harm EVERY cell in your body, period. thats hard biochemstry, facts, it is the truth.
red meat, on the other hand, is quite unclear.
the studies involving red meat are interesting;
people self report by remembering long periods of time, a salami pizza counts as red meat, as does a whole mc donalds burger with fries on the side.
as for nitrate, this gets complicating. you seem to be on the right path. nitrates are a new topic for me, i never before read up on them:
https://www.diagnosisdiet.com/assets/images/5/nitrate-content-45165560.png
https://www.bbc.com/future/article/20190311-what-are-nitrates-in-food-side-effects
https://livestock.extension.wisc.edu/articles/whats-the-deal-with-nitrates-and-nitrates-used-in-meat-products/
https://theconversation.com/why-nitrates-and-nitrites-in-processed-meats-are-harmful-but-those-in-vegetables-arent-170974
this is so tedious, no wonder everybody has a different oppinion
Perfect, let’s just get rid of public healthcare then
Until there is a diet that has long term success for a majority of its users I don’t think this mindset is healthy or realistic.
“According to the latest weight-loss research, 95% of dieters end up regaining the weight they lost within two years. Calorie-restricting diets are often successful at helping people lose weight, but they’re very unsuccessful at helping people maintain that weight loss.” source
https://diabetes.org/about-diabetes/genetics-diabetes#:~:text=Type 2 diabetes has a,also depends on environmental factors.
Now that you know you were cruel and wrong about diabetes, what do you have to say? What about the type 2 diabetics that have a perfect lifestyle and still have type 2 diabetes?