Health or Wealth? Tough Choice for Diabetics

Despite being diagnosed with diabetes just a few months ago, Perdue University graduate student Kristen Imboden, 22, is already disobeying doctor's orders.

Diabetics are encouraged to check their blood glucose levels several times a day to stay healthy. But Imboden admitted, "I've found myself testing [glucose levels] less frequently, so I don't run out of testing strips."

Imboden is not trying to rebel; rather, she is trying to budget. She is currently able to afford her medication under her parents' insurance plan, but will be dropped from this coverage on her 23rd birthday. Then, Imboden said, "I'll be transferring my supplies under my grad student insurance, which covers next to nothing."

As Imboden is quickly learning, being a diabetic can be very costly. A report released Tuesday by the Associated Press estimates that diabetes costs the United States $218 billion a year in medical bills, lost productivity and disability. And while some of these costs are only indirectly borne by those with the condition, the American Diabetes Association estimates that diabetics spend more than $20 billion of this sum on medical supplies alone.

Doctors recommend that glucose levels be checked up to 12 times a day for insulin dependent, Type 1 diabetics. One glucose test strip must be used for each of these checks. Without insurance; strips can cost consumers an average of 70 cents each, adding up to $3,000 annually for a person who checks as often as doctors recommend.

In total, health care expenses can cost each American diabetic more than $6,500 a year -- an expense more than twice what the average non-diabetic incurs -- according to the American Diabetes Association.

In addition to her prescription charges, "I wasn't fully prepared for the sudden increase in costs [with] doctor's visits, labwork, medicine, etc.," Imboden said. "I got a rebate for a phone I just bought. ... I thought maybe I could put it towards clothes ... but, instead, I thought, 'no, I have a refill coming up.'"

Stretching to the Limit

So what happens when diabetics are forced to choose between rent and refills? Many seek alternative ways to make ends meet, turning to generous doctors and foreign vendors if they have inadequate insurance coverage or funds.

Juanita Tharp, 74, of Fort Worth, Texas, said she has fallen into a "doughnut hole" in her Medicare coverage and must now pay out of pocket for her insulin.

"I've had a little help from my doctor giving me samples," she said, "because each vial of insulin costs nearly $100, and I use three a month."

Though Tharp's testing supplies are covered by Social Security and Medicare, the enormous cost of her insulin alone has forced her and her husband to dip into their savings.

"Any extras or ... trips or anything like that, no -- we just have to use this just to pay our bills and our medications," she said.

Tharp's situation has also led her to the increasingly popular Canadian market. There, insulin is "anywhere from $21 a vial to $43 a vial, plus your shipping -- which is still half the cost," she explained.

Paying the Price

A more extreme method for making supplies last is to eat less. For most diabetics, injections are given several times a day in relation to the amount of sugar and carbohydrates consumed. By consuming fewer carbohydrates, less insulin is needed.

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