Diabetics skimp on care in recession

Associated Press

Diabetics are increasingly risking life and limb by cutting back on — or even going without — doctor visits, insulin, medicines and blood-sugar testing as they lose income and health insurance in the recession, an Associated Press analysis has found.

Doctors have seen a drop in regular appointments with diabetic patients, if they come back at all. Patients more often seek tax-subsidized or charity care. And they end up in emergency rooms more often, patients and physicians said in interviews.

Sales of top-selling drugs and other products used to treat and monitor the disease have dropped since the economic crisis accelerated last fall, the AP analysis found. There are even signs that some patients are choosing less-expensive insulin injections over pricier pills to save money.

Meanwhile, the number of people with the disease keeps growing — an additional 1.6 million Americans were diagnosed in 2007 alone.

People with other health problems also are cutting back on care amid the recession, but diabetics who don’t closely monitor and control the chronic disease risk particularly dire complications: amputations, vision loss, stroke — even death.

Patients’ frugality comes at a tremendous cost to the already-strained health care system. The typical monthly bill to treat diabetes runs $350 to $900 for those without insurance, a price tag that’s risen as newer, more expensive medicines have hit the market. Emergency care and a short hospitalization can easily top $10,000, and long-term complications can cost far more.

M. Eileen Collins, 48, of Indianapolis, tried to scrimp on her medication last fall after her husband lost his job and with it their insurance. Without money for insulin, test supplies and other medicines, she asked for free samples and also got a few drugs through $4-a-month generic programs. But she stopped taking most of her drugs and cut her insulin doses in half to stretch her budget.

By Thanksgiving eve, Collins was vomiting blood and rushed to a hospital. Doctors diagnosed her as malnourished, anemic and in diabetic ketoacidosis, a life-threatening condition caused by sky-high blood sugar and lack of insulin. She spent a week in the hospital.

Sales of diabetes testing supplies and drugs indicate how many Americans have moved beyond scrimping and are cutting vital expenses.

Several doctors said they began noticing a shift in August or September, when the financial markets melted down and layoffs accelerated.

Sales have dipped for pricey brand-name diabetes pills, blood- glucose monitors and even test strips, based on industry sales figures and interviews with the top two makers of testing supplies.

Emergency rooms increasingly are treating diabetics who haven’t been taking medicines, according to doctors at several hospitals nationwide and the professional group for ER doctors.