Large global insurance company highlights central role of metabolic health

Swiss Re urges the healthcare industry to test for, prevent, and treat insulin resistance to save money and lives


Insurance company Swiss Re recently released a bold but accurate statement on the growing metabolic health crisis. The paper identified metabolic health as a common primary origin of non-communicable diseases and discussed how to prevent this root cause to reduce claims and mitigate costs. It’s a remarkable acknowledgment of the role of metabolic health in our collective global health and its impact on the bottom line of healthcare broadly.

Swiss Re, based in Zürich, Switzerland, is one of the largest reinsurers in the world. In October 2023, the company released a nine-page white paper about leading causes of death. The paper authors noted a common root cause thread largely ignored: insulin resistance. Reinsurance is when one insurance company buys insurance from another insurance company to help transfer risk. Swiss Re has taken the stance that the healthcare industry could save trillions in costs and millions in lives annually by creating strategies to prevent insulin resistance instead of letting the condition progress untested or untreated into a health crisis.

“Modern medicine, particularly when it comes to chronic conditions,” wrote the paper’s authors, “often takes a siloed approach—focusing on treating a specific pathology, or single risk factors and signs (like hypertension) rather than more broadly considering and treating the root cause.”

Dr. John Schoonbee, the company’s chief medical officer, co-authored the paper—the first of a series—with Swiss Re’s former life and health researcher. And Levels Adviser Dr. Benjamin Bikman peer-reviewed the document.

The financial and physical costs of poor metabolic health

According to the paper, poor metabolic health affects about half of adults globally and an even higher proportion in the United States. Nearly 75% of deaths result from non-communicable diseases. And, in high-income countries, poor metabolic health, which starts with insulin resistance, is a common root cause of the nine leading causes of death overall—eight of which are non-communicable diseases. This global metabolic health crisis costs the healthcare industry and families a combined total of more than $2 trillion per year.

“By helping to shift the health paradigm to include insulin resistance,” the authors wrote, “the insurance industry has the opportunity to not only improve the health of policyholders but also significantly reduce future claims for all lines of life and health business.”

Insulin resistance is testable, treatable, and preventable

Insulin resistance and related hyperinsulinemia (high insulin levels) affect every cell in the body. It is implicated in cardiovascular diseases, cancers, autoimmune disorders, dementia, and mental health issues. However, we can detect insulin resistance early and treat it with lifestyle changes to reduce the risk of many conditions.

“While we have known for 35 years that this clustering of conditions is very much associated with insulin resistance,” the authors noted, “the strategy and management of the syndrome has never focused on addressing this root cause.”

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Instead of testing for insulin resistance, physicians generally test glucose levels. The authors argued that without insulin resistance testing, the healthcare industry is missing a crucial opportunity for prevention.

“Unfortunately, insulin resistance testing has not yet entered mainstream medicine,” they wrote. “By focusing on insulin, rather than glucose, we can detect elevations in insulin up to a decade before glucose starts to climb.”

Prevention, the authors noted, often involves various strategies, including reducing carbohydrate intake, modifying the types of carbs consumed, eating macronutrients in a strategic order, engaging in intermittent fasting, and even wearing a continuous glucose monitor.

“Continuous glucose monitors,” they wrote, “are particularly beneficial to create the awareness of what food and food orders/combinations create the largest glucose (and hence insulin) spikes.”

Here’s hoping this message from such a mainstream and global source helps fuel more action at the ground level. 


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