The MENA region spends close to 20 bn USD a year on treating diabetes and its related complications. Diabetic expenses are forecasted to rise to 24.7bn USD in 2035 in UAE alone, increasing to 37bn USD by 2045. This rate of prevalence of the diabetes essentially re-classifies the disease as a pandemic and potentially has the ability to overwhelm economies and stress healthcare systems.
The condition has become so widespread and common, and society often forgets the financial impact it could have on one’s budget. We evaluated the typical cost a diabetic patient faces in the United Arab Emirates.
Medication
Both type 1 and type 2 require a well-known medication: Insulin. Metformin, Insulin, insulin pump supplies (test strips, lancets), home blood sugar monitoring kit are all recurring expenses that your insurance may or may not cover. Expat families in UAE are under serious financial strain trying to manage type 1 diabetes in younger children, with a typical month of expenses running up to a little more than $10001.
Effectively managed Type 1 diabetes-related medical costs can be anywhere from $15,000 for manual testing to $22,000 a year when a CGM (Continuous Glucose Monitoring) device is involved2. The use of CGM’s in diabetes management has become mainstream in most Western countries, but reimbursement issues have hindered its potential for scalable use in the UAE.
Well managed Type 2 diabetes and its related medical costs can cost between $9,000 to $10,000 annually3.
In cases of poorly managed Type 1 & 2 diabetes, sub-optimal care can lead to complications such as foot ulcers, high blood pressure, kidney failure, blindness etc., where costs can rocket much higher.
Doctor’s visits and timely screenings cost
For those suffering with diabetes, annual checkups of blood pressure, blood glucose levels, cholesterol, kidneys, feet, eyes, weight, and smoking status are recommended. These screenings may seem extra and unessential, but the cost of these tests is insignificant compared to the cost of any complications that may arise from neglecting these scheduled screenings. Quarterly doctors’ visits and screenings can sometimes go up to $480 a year, barring any complications3.
Undiagnosed cases cost
A major concern remains with the undiagnosed cases. In the MENA region, four out of every 10 adults are undiagnosed diabetic patients. What this means is that, if one remains undiagnosed, they are at a higher risk of developing complications due to spikes or dips in blood glucose levels. The more spikes or dips a patient gets without knowing it, the greater the complications down the line, and hence increased cost of managing these complications. This ties back to the effectiveness of CGM’s mentioned earlier in this article in monitoring blood glucose continuously and in real-time.
Mental health issues related cost
Diabetic patients may often struggle with feelings of stress, loss, anger, depression, anxiety and eating disorders. It is often seen that those who are newly diagnosed with this condition go through a phase of denial, that results in poor glycemic control. Considering the mental health of patients is an integral part of ongoing diabetes treatment, there is as much need to address these mental health concerns as there is need to address physical health issues.
Diet and lifestyle cost
According to the International Diabetes Federation, the diet and lifestyle cost of people with diabetes can be more than three times than for those without. Well balanced, all rounded nutrition is extremely important to keep your blood glucose levels at a standard functioning level. Specific foods that are diabetic friendly are not always friendly on your budget. Fresh produce, whole meal breads and low sugar snacks are invariably more expensive. Add to this the cost of a gym membership, and that makes a diabetic lifestyle more expensive than the average.
Forced trade offs
“With my existing medical expenses, there is no possible way for me to not live with my parents. I am 25, and want to live independently, but that is just not possible”, says a young diabetic patient, on condition of anonymity.
Having to ignore lesser important health concerns
“When I signed up for my health insurance, I couldn’t afford dental coverage. I have had to trade off on my dental health so I can get my core diabetes needs”, is the story of another anonymous individual suffering with diabetes.
What can we reduce the impact of diabetes to our budgets?
Increase in diabetic cases will lead to rise in demand for highly specialized medical services, which will consequentially impact the government’s health care expenditures. Regardless of how much providers try, type 2 diabetes is primarily a disease of habit, and those habits are not centered around a provider’s environment. Traditional ways of managing diabetes are often failing, and simply delay the myriad of secondary diseases such as microvascular diseases, diabetic retinopathy, diabetic foot, and renal failure.
The only way diabetes costs will go down is to fundamentally change the way providers are managing it. GluCare is dedicated to lowering costs by incorporating digital therapeutics that allow us to:
- Effectively and remotely monitor a patient all the time- and not just during clinic visits. GluCare collects data continuously and monitor real-time predictive risk scores.
- Two way communication between the provider (via a dedicated health coach) and patient. Trends that show spikes or dips in blood glucose can be managed effectively without needing to wait for the next patient appointment which can be many months later.
- Providing systematic and easily understood educational content throughout a 12 month via our app. Overloading a patient with paper brochures at each visit simply does not work.
Studies have shown that even a 1% reduction in updated mean Hemoglobin A1C, a key metric in measuring diabetes, was associated with reductions in risk4:
- 21% for any diseases that are caused related to diabetes
- 21% for deaths related to diabetes)
- 14% for myocardial infarction
- 37% for microvascular complications
Our aim at GluCare is to fundamentally change the way diabetes is managed by closing the feedback gap that exists between routine patient visits to the clinic. Low out-of-clinic compliance levels leads to poorer outcomes, further complications and more expensive overall care.
GluCare reduces the burden of self-management when the patient is out of the clinic. By incorporating our digital therapeutics platform as part of the routine diabetes management protocols to all our patients, we expect to reduce unnecessary visits to the clinic, improve adherence to management protocols and reduce overall costs to both patients and the system.
References:
- https://gulfnews.com/uae/crippling-cost-of-managing-diabetes-1.1101024
- https://www.sciencedaily.com/releases/2018/04/180412102930.htm#:~:text=At%20the%20end%20of%20the,the%20CGM%20device%2C%20about%20%242%2C500.
- https://www.healthline.com/health/cost-of-diabetes#3
- Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study
- BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7258.405
