Intended for healthcare professionals

Rapid response to:

Observations Body Politic

The travesty of expensive insulin

BMJ 2016; 353 doi: (Published 02 June 2016) Cite this as: BMJ 2016;353:i2933

Rapid Response:

Type 2 Diabetes : can we think differently and improve the management and control ? Perhaps by our "BRIJ PAL TECHNIQUE"

Dear Editor,

This news about insulin getting expensive and out of reach of millions of people against the wishes of its discoverers is quite disheartening. Perhaps the society and the lawmakers have to step in to restrain the market forces that are being allowed the unbridled freedom to overtake and overwhelm the costs of care and moving them beyond the reach of a common man. Medicine shouldn’t be seen being tipped in favour of the monetarily well endowed, but should be equally available for the poor and for the not so well endowed lot as well.

That said, we want to share out here a novel theory and innovative technique that can help people suffering from type 2 diabetes (T2D). We are of the view that in at least a significant number of cases the amount and dose of insulin and oral anti-diabetic medicines needed would be scaled down considerably. This we say because of our totally new theory/ hypothesis that we are exploring about adult onset diabetes, and perhaps of our having accidentally stumbled upon a more or less permanent solution as well. Nevertheless this will need lots of peer reviewed multi-centric global research, which is definitely beyond our scope as of now, as all we had was a pension of the prime author and just the very basics to go by.

We would like to state that one of our interests was in obesity and metabolic syndrome as well. For managing obesity, we had written about our “Dr. S. Arulrhaj’s non-invasive technique for flab and cellulite removal” [1], and we had described that technique in some details in our book [2]. Subsequently by having taken a cue from that technique and with some modifications, we had accidentally stumbled upon this new technique has helped in getting a better control of adult onset diabetes. With your permission we would like to name this new technique for managing Type 2 Diabetes (T2D) as “BRIJ PAL TECHNIQUE” after the name of the father of our prime author. As usual it has been our prime author was the first test case for this “BRIJ PAL” technique.

It is already established and known that by far T2D happens primarily due to two reasons. First and foremost being β cell dysfunction, and the second reason is the insulin resistance. We are of the view that adult onset diabetes is a result of ‘choked’ pancreatic acini that is unable to spurt out insulin in required amounts whenever needed. We may be wrong and stand for correction, but in theory we feel that this is primarily due to amyloid deposition within the β cells, and in and around capillaries and between cells. By having kept our new theory as stated above as a start point, we presume that by a modification of our ““Dr. S. Arulrhaj’s non-invasive technique for flab and cellulite removal” we can manage T2D in a substantially better manner. This new “BRIJ PAL TECHNIQUE” ‘explodes’ some parts of acini in a random fashion and empirically. We presume that this will predominantly be affecting the ‘choked’ cells. And with the choked cells out of the stage, rearrangement of acini could start happening after a short interval thereafter, along with some degree of clearance of amyloid from around the capillaries and between the cells. Since our “BRIJ PAL” technique also helps allay insulin resistance to some degree, it will help this way as well in achieving better diabetes control in Type 2 Diabetes (T2D).

In essence our technique helps to overcome the sort of stalemate that had happened which had led to choking of pancreatic acini and of the capillaries in the first place. Presumably this technique (that will be described in detail in our new book) improves the formation, release and supply of insulin, and in overcoming insulin resistance from three main sites, viz, liver, adipose tissue, and skeletal muscles [Figure 1-3]. This will possibly be leading to better control and management of T2D. We would finally like to reiterate that much more research is needed which is beyond our scope and would request the global medical and scientific fraternity to help improve this technique in the interest of millions of T2D patients worldwide, if it conforms to their reasoning and analysis.

Best regards.

References :

1. Chauhan R, Parihar AKS, Chauhan S. Re: The science of obesity: what do we really know about what makes us fat? An essay by Gary Taubes. BMJ 09 May 2013. Available at : (Accessed on : 03 June 2016)

2. Chauhan R, Chauhan S, Parihar AKS. Our non-invasive & painless ‘Dr. Arulrhaj Technique’ for flab and cellulite removal. In: Innovative Medical Techniques Showcased at International Conferences. LAP Lambert Academic Publishing (2014-10-17). ISBN 13: 978-3-659-62328-8; ISBN 10: 3659623288. Pp 59-64

Competing interests: 1. The views expressed here are in individual capacity, and have no bearing whatsoever to the affiliations or any official position of the authors. <br />2. The views, comments, ideas and figures given out here are a part of our new book.

03 June 2016
Dr (Lieutenant Colonel) Rajesh Chauhan
Consultant Family Medicine & Geriatric Medicine
Dr. Ajay Kumar Singh Parihar; Dr. Shruti Chauhan.
Honorary National Professor IMA CGP, INDIA
Family Healthcare Centre, 154 Sector 6 - B (HIG), Avas Vikas Colony Sikandra, AGRA -282007. INDIA.