Occasionally, Peggy Dator meets for the first time a new
patient with diabetes not at the free health clinic she
oversees, but at a local hospital.
Almost without fail, the reason is the same: the person is
uninsured and can’t afford medications used to control blood
sugar levels, said Dator. She’s the executive director of the
Ann Silverman Community Clinic in Doylestown that serves poor,
uninsured people who live in Central Bucks.
“It is people who know they’re diabetic, and, for whatever
reason, they’re in a jam,” she said, adding, “It’s not rare.”
Her experience is reflected in the findings of a report
released Tuesday that shows diabetes-related hospitalizations
in Pennsylvania increased 10.5 percent between 2000 and 2009.
The state’s hospitalization rates for diabetes are higher than
the national rate.
Hospital stays as a result of diabetes increased from 21,842 a
year to 24,143 a year over the nine-year period, according to a
Pennsylvania Health Care Cost Containment Council report
prepared with Bucknell Institute for Public Policy and the
Bucknell Public Interest Program.
Diabetes occurs when the pancreas doesn’t make enough insulin
or the body doesn’t use the insulin properly. An estimated 25.8
million people in the U.S. — 8 percent of the population —
The chronic disease is the seventh leading cause of death in
the United States and, if untreated, it can lead to serious
health complications requiring hospital care, including heart
disease, stroke, kidney failure, lower limb amputations and
Pennsylvania’s total diabetes hospitalization rate was 19.2
admissions per 10,000 admissions in 2009; the national rate was
17.7 per 10,000 residents. Admission rates in the state
declined among people age 65 and older, but increased among
those 18 to 64 years old, according to the report.
More than one out of every five (21.8 percent) Pennsylvania
patients hospitalized for diabetes in 2009 were readmitted at
least once within a one-year period for treatment of diabetes.
Among adults 18 and older, 9 percent said that they were told
by a doctor that they had diabetes between 2000 and 2009,
according to the Pennsylvania Health Department’s Behavioral
Risk Factor Surveillance Survey.
Locally, the diabetes rate was 14.2 and 15.5 for every 10,000
residents of Bucks and Montgomery counties, respectively, in
Statistics suggest that diabetes is more prevalent among the
poor. Pennsylvania adults with annual incomes of less than
$25,000 between 2006 and 2008 had a “significantly higher”
prevalence of diabetes compared to other income groups,
according to a 2010 state Department of Health report.
The disease is also expensive, costing at least $100 a month
for insulin and related supplies, estimated Dator, of the
Silverman clinic. She said one insulin-dependent clinic patient
needed $300 a month to maintain blood sugar levels.
“And for people without health insurance, that is a lot of
money,” she added.
While oral medications such as Glucophage are available in
cheaper generic forms, insulin is not. Blood glucose monitoring
equipment, such as meters, syringes, and test strips, as well
as lab work, are expensive, too.
Among adults with diabetes, 27 percent were taking insulin in
2009, according to the Pennsylvania Health Department’s
Behavioral Risk Factor Surveillance Survey.
At the Bucks County Health Improvement Partnership’s free adult
clinic in Bensalem, about 15 percent of the estimated 2,000
low-income and uninsured patients it treats have diabetes,
according to BCHIP manager and nurse practitioner Cathy
Giorgio. Many of those patients end up at the clinic as
“priority discharges” from local hospital emergency rooms,
where they are treated for uncontrolled diabetes, Giorgio said.
“It doesn’t surprise me at all. I’d say there are so many
uninsured people that don’t have routine diabetic management,”
Giorgio added. “If diabetes doesn’t get attention or runs out
of control, or testing isn’t performed … it’s pay me now, or
pay me later.”
Article source: http://www.msnbc.msn.com/id/45407822