The Economy Takes Its Toll on Diabetics

I was talking with a friend of mine who is a nurse practitioner and diabetic educator. She told me that there are a lot of patients these days not keeping their appointments at her diabetes clinic. Many of the no-shows have lost their jobs and with them, their health insurance plans. Oh sure, these folks are offered the COBRA option, but they can’t afford it.

One husband and wife who come to the clinic are both diabetics and are sharing their insulin. They can only afford enough for one, they say. Other patients say they can’t afford to buy good food and certainly can’t afford the expensive supplies required for monitoring their blood sugar.

My NP friend feels powerless. She gives out what samples she has, but she must ration them.“I feel like I’m playing God,” she says. “I go into work dreading it every day.”

You and I know what’s going to happen down the line. These diabetics are going to meet with disaster—expensive disaster. Maybe their crises will be small ones at first, but eventually they’ll find the nearest emergency room because the little crises have turned into big, serious ones. We’d like to think that the economy will pick up soon and that these people will return to work, but by the time that happens, the damage to their vessels will be done.

My friend’s clinic is a microcosm of what’s happening everywhere; diabetics are skimping on supplies and drugs. Experts don’t have to guess about this. The Centers for Disease Control and Prevention tracks the sales of diabetic supplies and drugs, and despite this growing number of diabetics—1.6 million Americans were diagnosed in 2007—sales are down.

It’s not hard to figure out why. According to what I‘ve read, the monthly cash costs for drugs and supplies of a diabetic with no insurance run between $350 and $900. The sad thing is that there are almost 18 million people with diabetes in the United States (and who knows how many undiagnosed cases). Most are Type 2, which means their diseases are probably preventable.

Sadly, Americans like to eat a lot and move too little, so nurses have a two-fold, uphill battle. We must motivate people to prevent diabetes by maintaining healthy lifestyles, and we have to help patients with diabetes to figure out how to take care of themselves so that they avoid heart attacks and strokes, and keep their kidneys, sight and legs.

Here in San Diego, the director of a large diabetic free clinic told the Associated Press that a third to half of their formerly middle class patients who have lost their jobs are not taking any medications. He added that the number of people seeking samples has recently grown by a third, and he used the word “rationing,” too.

Got ideas for solutions to this dilemma?

Please share them.