Diabetes is an expensive disease. Approximately 9.3% of Americans have diabetes and another 27% have pre-diabetes. In 2012, the estimated direct medical costs such as doctor’s visits, hospitalizations, and medications were $176 BILLION. Based on these numbers, diabetes alone accounts for 7% of the money we spend in our health care system. In addition, we lose $69 billion per year in reduced productivity – time off from work for doctor’s visits and hospitalizations, early disability, and early death all cost our society. The epidemic of obesity will only make these costs more staggering in the future. What can we do to improve these dreadful statistics? Importantly, if you have diabetes, what can you do to cut the cost of your illness?
There are two main classifications of diabetes. Type 1 diabetes typically occurs in childhood or young adulthood, and is an autoimmune phenomenon that destroys the ability of the pancreas to make insulin. Type 2 diabetes occurs when the body becomes resistant to the effects of insulin and eventually the pancreas burns out. Type 2 diabetes is usually adult onset and is the result of obesity and genetic predisposition. The obesity epidemic has significantly increased the number of children with Type 2 diabetes. The distinction between types of diabetes is important both in treatment and in financial implications.
Personal Cost of Diabetes
Many people think of diabetes as just a problem with “high sugar” levels. Have you ever spilled something sweet on your hands? It leaves them sticky and gross, especially if you can’t wash them and gunk gets on top of the sugar. Imagine your blood having high levels of a substance doing the exact same thing to your body. As it courses through your blood vessels, it coats all your organs, and here is what happens:
• Your heart becomes more susceptible to cholesterol and other lipids, leading to clogging of the arteries, which increases your risk of heart attacks.
• In fact, all your blood vessels become susceptible to fatty plaque build-up – increasing risk of strokes in your brain and arteries becoming clogged in your legs, which then results in a higher risk of amputations. And for the guys, it also decreases blood flow to your penis, making sexual performance a distant memory.
• The sugar messes up the function of specialized cells needed for vision and sensation – leading to blindness and neuropathy. When you can’t feel your feet, you can become easily injured, leading to yet higher risk of amputation.
Fortunately, taking good care of blood sugar levels improves lifespan and more importantly, quality of life. Of course, better health leads to lower health care costs. Let’s examine the financial cost of diabetes on a personal level.
• People diagnosed with diabetes incur medical expenses 2.3 times higher on average than those without diabetes.
• Poorly controlled diabetes makes it nearly impossible to get individual disability insurance, life insurance, and long term care insurance. There are policies available for those with well controlled diabetes, but for disability and long term care insurance, these policies can be expensive. Life insurance can be obtained for less well controlled diabetes, although at more expensive rates.
• If you take great care of your diabetes, you should only have to see your doctor no more than four times a year. However, if your diabetes is in poor control, you will see the doctor more often and end up in the hospital periodically. This will increase use of sick days and potentially affect your income.
• Diabetic patients need to follow a special diet, which includes a majority of healthy foods. Healthy meals are more expensive than the typical American diet.
Decreasing Out of Pocket Costs for Diabetes
The obvious way to decrease out of pocket costs for diabetes is to keep your blood sugar in good control through a healthy diet, exercise, and appropriate use of medication. By creating a consistent method of care, you can decrease doctor visits and stay in better health. Make this the bedrock of your care plan.
• Until your diabetes is in good control, keep a diary of when and what you eat. A great (and free) application to do this is MyFitnessPal.
• In conjunction with your diet diary, input your daily blood sugar checks. Your doctor may have you check your glucose anywhere from one to four times a day, depending on your medication and level of control.
• Be very consistent with taking your medication, whether it be insulin or oral medication.
• Show your doctor your diet diary and your glucose levels. If your glucose levels are in good control, they will back off on how often they need to see you. If your glucose levels are not in good control, you have provided the information they need to adjust your medications appropriately. Over time, if you are following your diet, you will obtain good control of your diabetes and visits will be less frequent.
Other tips to decrease out of pocket costs:
• According to Dr. Jennifer Shine Dyer, a pediatric endocrinologist, some health plans do a better job covering diabetic supplies. If you are responsible for purchasing your own insurance, make certain your plan covers what you are using. Ask your physician and health insurance agent to recommend plans that may better cover your needs.
• Generally, for those who need to go to the doctor often, copays and deductibles are maxed out each year. If you take great care of your diabetes, you may not see the doctor as often and your deductibles and copays may not max out. It may then pay to obtain a higher deductible plan with lower yearly premiums.
By becoming an empowered patient and taking care of your diabetes, good health and lower health care costs can be the lasting result.