Is the Healthcare System Working Against Those with Diabetes?

People trying to manage their diabetes face two unique hurdles that are built in to the current healthcare landscape.

Receiving a diagnosis of a chronic health condition — or, an illness that requires ongoing care — is never easy. There’s a lot to consider. How will this condition affect how I feel every day? How is my daily routine going to have to change? How much are my medications and other treatments going to cost?

Those with diabetes deal with all of those challenges, and more — some of which are unique to diabetes. Here are two, and what you can do about them.

Bias in the healthcare system

An unfortunate fact: our society regularly exhibits bias against those who are overweight or obese. The stigma overweight people face can affect how they’re treated at work, at school and even at their doctor’s office. A survey of more than 2,000 doctors concluded that weight bias is as common among physicians as it is among the general public.

While not all people with type 1 and type 2 diabetes are overweight, many are. It’s estimated that about 50% of people with type 1 and about 90% of people with type 2 diabetes are overweight or obese. That comprises a large portion of those living with diabetes who are subject to negative bias when working with a physician to manage their condition.

Further, there is a commonly-held assumption that those with diabetes are to blame for their disease. While risk factors include age, family history, medical history and comorbid health conditions, many overlook those considerations and approach diabetes solely as a lifestyle-induced condition.

Physician bias related to patients’ weight can do more than make people uncomfortable or lower their self-esteem — it can negatively affect health outcomes, too. When doctors express bias toward their patients, a few things can happen.

First, doctors may spend less time with these patients during appointments and provide less health education counseling. Second, when patients feel they are being stigmatized, they are less likely to seek follow-up care from a physician, which can be detrimental to the successful management of a condition that requires regular check-ins and potential treatment adjustments. Third, when a diabetes patient perceives that he or she is being stigmatized while interacting with a doctor, the resulting stress responses can make it more difficult to absorb new information — a significant barrier when it comes to learning how to successfully manage their condition.

It’s likely that, as might be true for much of the general public, these biases are not intentional or mean-spirited. But the consequences are real. Put simply: those seeking help from a doctor to manage their diabetes could be getting lower-quality healthcare than those with other chronic conditions.

High out-of-pocket costs

People with diabetes have medical expenditures 2.3 times higher than those without diabetes, on average. While those with health coverage have the benefit of getting help with those costs from their health plan, more and more plans are increasing their cost-sharing requirements, placing more out-of-pocket cost burden on the patient. These types of plans expose all consumers to financial risk, but diabetic patients may be more likely to experience the financial pitfalls of these high out of pocket costs.

For those without health coverage, footing the entire bill for blood glucose monitoring supplies, medication, and/or insulin can seem nearly impossible. Insulin, which is a non-negotiable need for type 1 and some type 2 diabetics, has exhibited atypical pricing trends in the marketplace; prices haven’t notably dropped even when competition in the market increased.

Unaffordable treatment leads to medication nonadherence — or, people not taking their medications as prescribed. For diabetics, the consequences can be serious and immediate. A recent study showed that 16.5% of people with diabetes experienced cost-related medication nonadherence, with the incidence being even higher for those who used insulin.

What you can do

A reduction in physician weight bias could be achieved by providing issue-specific training to doctors. You can facilitate this and help the issue gain more exposure by reporting your experience to the Obesity Action Coalition.

To help with costs, be sure to check Blink to see if there’s a cheaper price available for your metformin, glipizide, glimepiride, pioglitazone, insulin, or testing supplies like your glucose meter or testing strips. You can also save money on your Lilly insulin prescription through Blink.

This article is not medical advice. It is intended for general informational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.

Blink Health is not insurance. Blink Health Administration, LLC, 233 Spring Street, 8th Floor East, New York, NY 10013, (844) 366–2211, www.blinkhealth.com