“Fear That One Day I May Not Be Able to Afford Insulin”: The Emotional Burden of Diabetes Costs During Emerging Adulthood

Vitale, Rebecca; Wentzell, Katherine; Laffel, Lori M.

doi:10.1089/dia.2022.0170

Cited by 8 publications

(4 citation statements)

References 19 publications

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“…Affordability, accessibility, and feasibility of implementing the diabetes care plan are major considerations in shared decision making. In the US, the high and rising costs of insulin and non-insulin drugs 145 have contributed to diabetes distress, 146 cost related non-adherence 147 148 with a detrimental effect on diabetes health outcomes 149 and rationing of other vital expenses. 150 Therefore, healthcare providers must discuss concerns about affordability with all people with diabetes, ensure that prescribed drugs are available and accessible, and leverage care team and community support systems to reduce the financial burden of the management of diabetes.…”

Section: Equity and Affordability Of Diabetes Carementioning

confidence: 99%

Advances in the management of type 2 diabetes in adults

Galindo,

Trujillo,

Low Wang

et al. 2023

bmjmed

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Type 2 diabetes is a chronic and progressive cardiometabolic disorder that affects more than 10% of adults worldwide and is a major cause of morbidity, mortality, disability, and high costs. Over the past decade, the pattern of management of diabetes has shifted from a predominantly glucose centric approach, focused on lowering levels of haemoglobin A1c(HbA1c), to a directed complications centric approach, aimed at preventing short term and long term complications of diabetes, and a pathogenesis centric approach, which looks at the underlying metabolic dysfunction of excess adiposity that both causes and complicates the management of diabetes. In this review, we discuss the latest advances in patient centred care for type 2 diabetes, focusing on drug and non-drug approaches to reducing the risks of complications of diabetes in adults. We also discuss the effects of social determinants of health on the management of diabetes, particularly as they affect the treatment of hyperglycaemia in type 2 diabetes.

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Section: Equity and Affordability Of Diabetes Carementioning

confidence: 99%

Advances in the management of type 2 diabetes in adults

Galindo,

Trujillo,

Low Wang

et al. 2023

bmjmed

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“…Recent qualitative work has explored the impact of financial burden on the lived experience of emerging adults with T1D. These studies identify that emerging adults carry substantial emotional distress related to managing diabetes costs (26)(27)(28). A recent report showed that 90% of emerging adult participants expressed worry related to the costs of their diabetes.…”

mentioning

confidence: 99%

“…A recent report showed that 90% of emerging adult participants expressed worry related to the costs of their diabetes. In open-ended responses, they characterized their concern using words such as 'fear,' 'overwhelm,' 'isolation,' and, 'limitation' (26). In another report, participants explained that the challenges in affording diabetes supplies can delay age-appropriate maturation and financial independence, as they must rely on their parents for financial support for longer than their peers without diabetes (27).…”

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confidence: 99%

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Financial stress in emerging adults with type 1 diabetes: a mini review integrating lessons from cancer research

Wentzell,

Nagel

2024

Front. Clin. Diabetes Healthc.

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Amongst adults in the United States, those ages 18-30 have the highest unemployment rates, the lowest incomes, and are the most likely to be uninsured. Achieving financial independence is a core developmental task for this age group, but for those with type 1 diabetes (T1D), the high costs of insulin and diabetes supplies as well as an employment-based insurance model with minimal safety net can make this a formidable challenge. Cost-related non-adherence to diabetes management is particularly high in emerging adults with T1D and is associated with severe consequences, such as diabetic ketoacidosis (DKA) and even death. Objective financial burden and subjective financial distress related to illness are not unique to diabetes; in cancer care this construct is termed financial toxicity. Researchers have identified that emerging adults with cancer are particularly vulnerable to financial toxicity. Such research has helped inform models of care for cancer patients to mitigate cost-related stress. This mini review aims to briefly describe the state of the science on financial stress for emerging adults with T1D and explore parallels in cancer scholarship that can help guide future work in diabetes care to reduce health inequity, drive research forward, improve clinical care, and inform policy debates.

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