The daily life of a person managing diabetes feels many costs: at work, on relationships, at play, during sleep, on time, on mental health, and to be sure, on personal finances. The True Cost of Diabetes report from Upwell details the many tolls on the person with diabetes.

The first-order impact for a patient engaging in self-care to manage diabetes is time that the many tasks in a day borrow from work, sleep, home-keeping, and relationships. Seventy percent of PwD (people with diabetes) checks blood sugar at least once a day (41% one to two times, 29% three to five times). Nearly one-half of PwD take diabetes meds twice a day; 24% take meds three or four times everyday. Nine in ten PwD go to a physical pharmacy at least once a month.

Consider food, another key self-care component for a person dealing with diabetes. One-third of PwDs spend up to two extra hours a week shopping for and preparing healthy meals, and 14% spend up to five hours more a week to deal with good meal preparation. That task involves considering carbohydrates (healthy ones like vegetables and some fruits, versus white carbs like potatoes and rice). Following a healthy diet can help the person with diabetes maintain healthy blood glucose levels — literally the lifeblood for this patient.



Diabetes’s toll on daily living is non-stop. When it comes to work, 55% of PwD missed work in the past year due to the condition: 39% of folks missed up to five days of work. Diabetes impacts peoples’ leisure-time activities — that would be “fun” — as well, with nearly one-half of PwD having to miss a planned outing or other personal event due to diabetes. One-third of PwC had to give up a hobby or interest.

Sleeplessness is an epidemic whether or not you are diagnosed with diabetes. For people with the condition, most say diabetes complications interrupts sleep every week. Those complications could be waking up in the middle of the night with low blood sugar, causing sweats, shakes, dizziness, or confusion. This requires a quick fix of a healthy carbohydrate.

The personal financial impact of diabetes is formidable. “Living with diabetes isn’t cheap,” Upwell observes. The fiscal bottom-line for PwD: 1 in 2 patients has sometimes gone without diabetes care due to cost.

Finally, there’s mental health: over one-half of PwD are worried about the future, and 39% report depression. Relationships can suffer; diabetes is an illness that impacts a person’s direct social network, family, close friends, and work colleagues. Caregivers may get stressed, partners and children can worry about the future, too.

Upwell Health surveyed 5,255 people with diabetes online in 2017.

Health Populi’s Hot Points:  America is the United States of Diabetes when it comes to healthcare spending. Care for people with diagnosed diabetes accounts for 1 in 4 health care dollars in the U.S.

The total estimated cost of diagnosed diabetes in 2017 is $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity, the American Diabetes Association calculates. The bulk of medical costs comprise,

  • Hospital inpatient care (30% of the total medical cost),
  • Prescription medications to treat complications of diabetes (30%),
  • Anti-diabetic agents and diabetes supplies (15%), and,
  • Physician office visits (13%).

People diagnosed with diabetes have average medical spending of $16,752 per year, which is about 2.3 times greater than what healthcare costs would be without diabetes.

Today I benefited from listening to Timothy Jost, professor emeritus of healthcare law at Washington and Lee University, and Stephanie Armour, health policy reporter at The Wall Street Journal. The session was sponsored by the Center for Health Journalism at the Annenberg School. Jost and Armour discussed the ramifications of the U.S. Department of Justice effort to erode the Affordable Care Act.

People with diabetes have, by definition, a pre-existing condition when they seek health insurance. The impact of eliminating this facet of the law would take a huge toll on the diabetes community’s financial health and access to services. In the current environment, one in two PwD is already avoiding some care due to costs. When more people with diabetes lose health insurance coverage, they lose access to on-ramps for healthcare services.

Be careful what you wish for, those who want to take this provision away. People with diabetes come in all political stripes, and have strong health advocates on the ground both organizationally (say, the American Diabetes Association and various clinician specialty and primary care groups) and patient activists. This issue will be top of mind for health care voters in the 2018 midterm elections, which recent polls say is a whole lot of U.S. voters.