When cells are resistant to insulin, they don’t use the insulin effectively to bring the glucose from the bloodstream into the cell. The pancreas needs to produce more insulin to overcome this resistance in an effort to normalize blood sugar levels. When the pancreas can’t keep up with the insulin demands in a person with insulin resistance, that person develops diabetes.
Anecdotally, Cummings knows at least one person in the US who got their surgery paid for through their partner’s employer insurance, despite only having a BMI of 31. And he notes that many countries with a robust public health care system have already lowered their BMI limits to mirror the DSS-II guidelines, such as the UK and Saudi Arabia. He also believes that Medicare and Medicaid officials are deliberating whether to adopt the DSS-II guidelines, based on discussions he’s had. “I don’t know how long it’ll take, but we’re crossing our fingers and hoping,” he said.