Diabetes Forecast

A Call to Arms

By Henry Rodriguez , ,

I have previously written here about the challenges that face people with diabetes and the exciting innovations that have the potential to address those challenges. Unfortunately, in the United States, access to the tools that help people improve their blood glucose control is all too often limited by restrictions imposed by health insurance companies and other third-party payers. At the same time, congressional funding for research into diabetes is in jeopardy. I would like to take this opportunity to promote a "call to arms." People directly affected by diabetes and the tremendous numbers of us who are indirectly affected must strongly advocate for changes in our health care policy. No matter what your political persuasion, there can be little doubt that addressing this issue is both figuratively and literally vital to the health of our nation.

I am not suggesting that the solution is an easy one. But it is crucial that we improve awareness of the "diabetes epidemic." The increasing incidence of both type 1 and type 2 diabetes has been well-documented, as has the projected toll of failing to stem the tide. The potential cost in terms of morbidity and mortality and the financial expense of direct health care expenditures and lost wages are staggering. We must act now!

As a pediatric endocrinologist, I am all too aware of the increasingly higher hurdles that families must surmount to secure insurance coverage for basic diabetes care supplies such as blood glucose test strips, urine ketone strips, and injectable glucagon. Innovations aimed at decreasing the burden of diabetes care and consequently improving adherence to treatment regimens have been met with greater scrutiny and opposition by payers. Products including blood ketone monitoring devices, insulin injection pens, and insulin pumps are inconsistently covered, and the process of seeking coverage for newer technologies—even once they are U.S. Food and Drug Administration-approved—is daunting. The need for prior authorization and onerous multiple appeals has become commonplace.

The current status of diabetes research funding is equally troubling. In my roles as a clinical researcher and a scientific grant reviewer, I am witnessing the effects of diminishing federal funds for new and ongoing diabetes research. This has resulted in a greater demand upon nonprofit organizations such as the American Diabetes Association and the Juvenile Diabetes Research Foundation. Greater competition for limited funds has far-reaching effects including less money for new investigators, meaning that researchers will no doubt move to other areas of research; decreased funding for innovative but "riskier" avenues of investigation; and less ambitious goals for currently funded investigators faced with the possibility of disappearing support.

I urge you all to educate yourselves about the current status of diabetes care and research and the looming threat of diabetes in the future. Then go out and advocate for initiatives that will address current and future needs. The present economic climate has required our lawmakers to critically review all expenditures. Let's do all that we can to ensure that diabetes remains at the forefront of their deliberations—for the sake of those who are currently affected, and for the countless others who will develop diabetes if we fail.

Interested in getting involved? Call 1-800-DIABETES or visit www.diabetes.org.



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