Diabetes, Covid, and Profit: A Love Story
By: Nathaniel Lapp
Tags: Vaccines, Insulin, Covid 19, Diabetes

Diabetes Mellitus is a chronic disease where the cells of the body are unable to convert blood glucose (sugar) into energy. There are two primary kinds of the disease: Type one, caused by an immune response that incorrectly targets the cells of the pancreas that produce insulin; and type two, caused by the body’s inability to effectively use the insulin it produces. Type one diabetes represents about ten percent of all diabetes cases in the world while type two occupies the other ninety percent.

Diabetes is one of those diseases that is treatable. In many cases it’s possible to reverse or prevent type two diabetes but those with type one are unable to be cured despite the frequent articles about stem cell or transplant studies every few years.

That clear, funny-smelling liquid keeps us alive every day. Without it, we die. Before insulin was available, type one diabetes was a death sentence and the best care consisted of starvation diets. Insulin injections prevent death and let us live relatively normal lives. The trick is that poorly-treated diabetes can lead to terrible conditions like loss of eyesight, neuropathy, cardiovascular complications, and amputation of limbs.

To mitigate these complications companies have developed tools to help us manage our blood sugar. Glucometers let us check our blood sugar in seconds; insulin pumps administer small doses of insulin constantly; and continuous glucose monitors (CGMs) track our blood glucose constantly. Recent developments in the sensor technology make them more accurate, easier to use, and capable of guiding the insulin pump on their own.

The problem with all of these treatments is one simple, ubiquitous thing: money.

From the BBC (https://www.bbc.com/news/world-us-canada-47491964)

Insulin costs money. Needles for insulin cost money. The disposable strips that you put blood on to check your blood sugar cost money. Insulin pumps cost money. The continuous glucose monitor and the insulin port for the pump cost money. Any sacrifice in care you have to make is a risk to your health. If you don’t make enough money to pay for a CGM that your doctor knows will improve your blood sugar averages you’re putting your health at risk. When you have to cut back on the number of blood sugar tests per day to save money, you’re putting your health at risk. When you have to ration your insulin, you’re putting your life at risk.

The price of insulin has been a feature of American politics since 2015 because it is so high and has been rising despite no or minimal changes to the drugs. While American diabetics are paying exorbitant rates to live, the out-of-pocket cost of any diabetes product is a financial burden. In the United States, diabetics’ average medical costs are 2.3 times higher than a non-diabetic. In 2017, $237 billion USD was spent on diabetes care in the United States among people ages 20–79 compared to $727 billion USD worldwide (62). That means that approximately one-third of the global cost of diabetes was spent in the United States, but only 6.7 per-cent of the world’s diagnosed diabetics aged 20–79 (according to 2019 data) live in the United States (41, 45). Why are Americans paying one third of the world’s diabetes cost yet represent less than seven percent of world’s diabetics? Our for-profit healthcare system. While some of the quantity of dollars spent can be attributed to the availability of the aforementioned tools like CGMs, this 2018 survey found that about one-quarter of American diabetics ration their insulin, while in “high income” countries only 6.5% of diabetics ration their insulin.