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Those living with Type 2 diabetes say they deal with fear and stress when it comes to their condition, with expenses and mental hardships becoming almost as burdensome as the disease itself – which is fostering distrust in the healthcare system, according to findings from a new survey.
The survey, conducted by clinical and patient support services company Podimetrics, found that more than half (53%) of people living with Type 2 diabetes fear complications from their condition may ultimately result in their death. And about 25% reported requiring emergency care for a Type 2 diabetes complication, with a notable 62% of that group revealing that their emergency care was for a life-threatening issue. 
It was also revealed that 32% of people living with Type 2 diabetes don’t trust the U.S. healthcare system to keep them healthy. That raises the possibility that hospitals and health systems may need to do more to foster a sense of trust.
Yet while the numbers are distressing, this population also faces a whole host of other significant issues around managing their chronic condition, including mental health and financial stressors.
According to the survey, 50% report experiencing mental health issues as a result of managing their condition, and 45% face serious financial strain resulting from exorbitant costs of care. According to the Centers for Disease Control and Prevention, diabetes is the most expensive chronic condition in the U.S., and $237 billion is spent each year on direct medical costs and another $90 billion on reduced productivity.
Still, mental health and financial challenges are only part of larger issues facing people living with Type 2 diabetes. Amputations are another major concern. The data showed that 49% worried their diabetes may lead to a limb amputation one day.
Access to high-quality, affordable healthcare remains a nationwide problem, especially for individuals living with Type 2 diabetes, the survey found.
About one in six report that seeing a doctor is too difficult, with a lack of appointment availability being the biggest barrier (58% of this particular group), followed by high costs of care (44%) and transportation challenges (34%). Making matters worse, a majority (58%) of respondents said America’s healthcare system focuses on treating illnesses, rather than preventing them.
On top of that, a portion of those with the condition perceive their healthcare quality as inferior to others. Overall, the survey found that roughly one in five believe they don’t have access to the same level of care as others in their state with Type 2 diabetes. Sixty percent cited healthcare affordability as a big barrier; 36% indicated race as a contributing factor; and 30% mentioned that the area in which they live had lower-quality providers or care access challenges.
Drilling down deeper into the effects among racial and ethnic minority populations, the findings showed Black people are up to four times more likely to suffer from an amputation resulting from diabetic complications – and Indigenous people are up to twice as likely.
Also uncovered were findings that reinforce the serious disparity problems facing minority populations that have been diagnosed with Type 2 diabetes. For instance, Black respondents were more likely (31%) to have experienced a medical emergency because of a diabetes complication, compared with the full survey sample (25%).
Yet it’s Hispanic individuals who are increasingly being impacted by the challenges and disparities created by living with the condition. Sixty-seven percent reported mental health issues (compared with 50% for the broader sample); 65% feared Type 2 diabetes would cause their death (compared with 53%); 63% reported facing financial strain (compared with 45%); and 40% reported needing emergency care because of a diabetic complication (compared with 25%) – with 74% of that group indicating it was a life-threatening situation (compared with 62% for the broader sample).
A June report published in Health Affairs showed that existing diabetes quality metrics don’t currently help patients improve their health, and diabetes quality measurement must be improved through the adoption of new measures and modernization.
Current quality measures don’t safeguard against inappropriate treatment or overtreatment and, in fact, incentivize providers to focus on patients most likely to achieve the measures currently in place, rather than those who would benefit the most clinically, the report said.
Combating diabetes has become an area of increasing focus for healthcare providers – Geisinger has taken on diabetes reversal through grants, philanthropy and executive buy-in by piloting Fresh Food Farmacy in locations with a population of Type 2 diabetes patients.
Type 2 diabetes reversal has also been the focus of a Banner|Aetna partnership with Virta Health. The collaboration gives Banner|Aetna’s fully insured and employer group members access to the virtual, provider-led diabetes program.
CareFirst BlueCross BlueShield recently awarded $1.76 million to grantees addressing the diabetes epidemic, with the funding aimed at organizations working to address the upstream social determinants of health impacting the likelihood of developing diabetes.
And in June, California Governor Gavin Newsom said the state’s budget would set aside $100 million for the development and manufacture of low-cost insulin products.
Twitter: @JELagasse
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