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Diabetes and The American Healthcare Dilemma

Updated: Jun 28, 2020

By Lizzie Quinn

Graphic by Senching Hsia, Graphics Editor

Tackling the Stereotypes of Diabetes: What is Diabetes?

The most popular misconception surrounding diabetes is that it is a disorder solely found in overweight individuals, which is not the case. These misconstrued notions of diabetes need to be shoved aside, as diabetes- and insulin-related news articles sweep media platforms worldwide.

Diabetes encapsulates an array of disorders that involve complications with the hormone insulin. The pancreas — an organ located behind the stomach — normally releases insulin to help the body store and use the sugars and fats from food intake as energy. There are two types of diabetes: either the pancreas produces reduced amounts of insulin, or the body does not respond normally to insulin at all. A diabetic may also have an impaired ability to process blood glucose, also known as blood sugar. Thus, those with diabetes need to manage their disease by monitoring food intake and blood glucose to stay healthy, for there is no current cure for inconsistent blood glucose levels.

The Types of Diabetes

An estimated 30.3 million Americans live with diabetes. This number equates to around 9.4% of the nation’s population.

The three main types of this metabolic disorder are type 1, type 2, and gestational. There is also a pre-diabetes stage referred to as impaired glucose tolerance, where blood sugar levels are slightly higher than the normal average range but are low enough to not be classified in the diabetes range.

Type 1 diabetes, or T1D, is an autoimmune disease that affects around 1.25 million Americans, and an anticipated total of 5 million in the US by 2050. T1D is referred to as juvenile diabetes because people diagnosed with it are typically under the age of 20. Those with T1D have pancreas cells that produce little to no insulin.

Type 2 diabetes, known also as noninsulin-dependent diabetes, is usually preceded by pre-diabetes. It is most prevalent in adults, but it is becoming more common among children as childhood obesity increases. 29.1 million Americans have Type 2 diabetes, while another 1.4 million people are diagnosed every year in the US alone. This increasingly prevalent but largely preventable disease is caused by old age, excess weight, unbalanced diet, or a family history of having the disease. This branch of diabetes is considered a lifestyle disease because it is normally triggered by living a rather sedentary life, unlike its autoimmune counterpart T1D.

Gestational diabetes affects pregnant women. Unlike other forms of diabetes, gestational diabetes results from increased hormones during pregnancy. These increased hormones — specifically, an abundance of human chorionic gonadotropin hormone (hCG) and estrogen — may make one’s body resistant to insulin.

The American Healthcare Dilemma

Ways to effectively manage diabetes have become more innovative with modern technology. Ultra rapid insulin and smart insulin — emerging technologies that improve blood glucose control — more rapidly correct hyperglycemia (excess glucose in the bloodstream) than mainstream constant glucose monitors or self-administered injections.

It might shock you that the United States alone spends 17.8% of its gross domestic product — or roughly $3.2 trillion — on healthcare. This massive amount of money isn’t only equal to Germany’s economy, but could also put roughly 25 million Americans through four years of college.

Interestingly, the American healthcare dilemma isn’t the absence of fundin, but the lack of care attributed to the nation’s population. In the case of diabetes, the U.S. focuses far too much of its resources and research on simply managing the disease. And for what? To scrape the pockets of the average American diabetic, fishing out every last cent until Americans are forced to ration their insulin and succumb to this deadly disease?

Type 2, gestational diabetes, and pre-diabetes don’t plague someone for the entirety of his or her lifetime. Those who develop T1D, on the other hand, have the disease for life and will need treatment through insulin shots or an insulin pump. It must be reiterated that insulin therapy alone cannot be a cure.

Nicole Smith-Holt from Minnesota is demanding a change to the price of insulin after her 26-year-old son, Alec, died from diabetic ketoacidosis in the late June of 2017. When Alec grew too old for his parents’ health insurance on June 1, 2017, he began to ration his insulin so as not to spend over $2,000 per month. Alec lasted less than a month under these low-insulin conditions. Since then, his mother has begun rallying for a change.

Alec’s case is not rare, and with the tripling of the price of insulin over the last decade, cases like Alec’s will occur more frequently. The American Diabetes Association estimates that the total costs of diagnosed diabetes — including regular endocrinologist visits and insulin therapy — have risen from $245 billion in 2012 to a staggering $327 billion in 2017. $237 billion went to direct medical costs, and the remaining $90 billion summed up the costs of reduced productivity.

Focusing on the backwardness of the American Healthcare crisis, Shreya Kangovi of The Boston Globe said, “Our [healthcare] system is stuck in the 1950s, when the prevailing epidemics were polio and influenza.” She continued, “Half of all adults—117 million Americans—have a chronic condition; the projected cost is $794 billion in lost productivity alone between 2016 and 2030.”

The amount of diagnosed cases of diabetes — especially Type 2 — will continue to increase as adult obesity levels reach extremes. Type 2 diabetes is a manageable disease, but, similar to its autoimmune counterpart T1D, has deadly consequences if left unmanaged. Moreover, the issue of overpriced insulin unwinds inner threads of the dilemma in American healthcare as a whole, not just among the 30.3 million Americans with diabetes.


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