Diabetes & Medicare News

50 Diabetes Statistics Every Care Provider Should Know

Caretakers, educators, doctors, students, and people with diabetes themselves are often curious about national diabetes statistics. So, we took a look at some of your common questions and provided the figures to answer each of them. We hope this will help you to better understand diabetes and its associated risks, costs, and treatments.

How many Americans have Type 1 and 2 diabetes?

As of 2014, an estimated 422 million people worldwide are estimated to have diabetes. (Word Health Organization)
An estimated 23.1 million people in the U.S. have been diagnosed with diabetes. That’s an average of 7.2% of the U.S. population. (CDC, 2017)
An additional 7.2 million people in the United States are estimated to have undiagnosed diabetes, making the total estimated sum of diabetic Americans 30.3 million. (CDC, 2017)
An additional 2.9% of Americans are estimated to have undiagnosed diabetes. (CDC, 2017)
5% of diabetics are diagnosed with Type 1 diabetes; the rest have Type 2 diabetes. (CDC, 2017)

What is the prevelance of diabetes based on demographic details like age and race/ethnicity?

193,000 children and adolescents under 20 years of age (0.18% of the U.S. population) have been diagnosed with diabetes (CDC, 2017)
89% of people with diabetes are aged 45 and older. (CDC, 2017)
Prevelance is significantly higher among American Indians/Alaska Natives (an estimated 14.9% of males and 15.3% of females have diabetes in this demographic). (CDC, 2013)
Prevenance is also higher amongst Hispanic (12.6% males; 11.7% females) and non-Hispanic blacks (12.2% males, 13.2% females). (CDC, 2013)
Prevelance is lower amongst Asian Americans (9.0% of males and 7.3% of females) and non-Hispanic whites (8.1% of males and 6.8% of females). (CDC, 2013)
12.6% of adults with less than a high school education have diagnosed diabetes, compared to 7.2% of those with most than a high school education. Of those who graduated high school, 9.5% have a diabetes diagnosis. (CDC, 2017)

The above figures and heat map are from the Center for Disease Control (CDC) National Diabetes Statistics Report, 2017.

How common is prediabetes?

Prediabetes is determined based on a person’s fasting glucose or A1C level. When these levels are too high, a person is diagnosed with prediabetes.

An estimated 33.9% of U.S. adults 18 and older have prediabetes (CDC, 2015).
However, only 11.6% have been told by a health care professional that they have this condition, making it commonly undiagnosed. (CDC, 2015)

What are the reasons people diabetes are hospitalized? How often do hospitalizations occur?

The yearly total of hospital discharges for diabetes-related illnesses is 7.2 million. (CDC, 2014)
The yearly total of emergency department visits for diabetes-related complications is 14.2 million. (CDC, 2014)
The leading causes of these discharges are major cardiovascular disease (1.5 million), lower extremity amputation (108,000), and diabetic ketoacidosis (168,000). (CDC, 2017)
- Note: to prevent foot or leg amuptation, it is recommended that people with diabetes take advantage of Medicare’s diabetic shoe coverage. Click here to learn more.
An estimated 36.5% of U.S. adults with diagnosed diabetes have a crude prevelance of kidney disease. (CDC, 2017)

How common is diabetic neuropathy and other foot-related issues?

An estimated 30 million Americans have some form of peripheral neuropathy. (Foundation for PN)
Between 60%-70% of Americans with peripheral neuropathy (18-21 million) have diabetic neuropathy. (Foundation for PN)
Acout 60-70% of people with diabetes have some form of diabetic nerve damage. (California Podiatric Medical Association)
During their lifetime, 15% of people with diabetes will experience a foot ulcer. Of this group, 14-24% will require amputation. (California Podiatric Medical Association)
Each year, more than 82,000 amputions are performed among people with diabetes. (California Podiatric Medical Association)

How much does diabetes cost Americans each year?

The total direct and indirect cost of diagnosed diabetes in the U.S. is estimated as $347 billion as of 2017. This includes $237 billion in direct medical costs and $90 billion in reduced productivity. (ADA, 2018)
The cost of diagnosed diabetes treatment has increased 26% over a 5-year period, from $245 billion in 2012 to the current $347 billion figure. (ADA, 2018)
Hospital inpatient care makes up 30% of these costs, while prescription medications are another 30%. (ADA, 2018)
The average annual medical expenditures for a person with diabetes is $16,752. Of that, an estimated $9,601 is used towards diabetes-related expenses. (ADA, 2018)
Medical expenditures for those with diabetes are approximately 2.3x higher than they would be without diabetes. (ADA, 2018)
In the U.S., 66% of costs related to diabetes are provided by government insurance (ie. Medicare, Medicaid, the military). (ADA, 2018)To see a list of all diabetic support products and services covered by Medicare, click here.

To order diabetic shoes covered by Medicare, click here.

Sources:
Center for Disease Control (CDC). National Diabetes Statistics Report. 2017.
American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2017. Published by Diabetes Care, March 2018.

Mathers CD LoncarD. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med, 2006. 3(11):e442 – statistic republished via World Health Organization

The Foundation for Peripheral Neuropathy, Peripheral Neuropathy Risk Factors + Facts, accessed Oct. 2018.

California Podiatric Medical Association, Facts of Diabetes and the Foot, accessed Oct. 2018.

8 Eye-Opening Quotes from Famous People with Diabetes

With more than 100 million Americans living with prediabetes and diabetes, it’s no surprise that people with the diagnosis come from all walks of life. But some may be surprised just how many familiar faces and A-list celebrities balance diabetes management with superstardom. Diabetics in the public eye are often asked questions about their diagnosis, and their answers can be inspirational and enlightening. Here are 8 of our favourite lines from people with diabetes in the spotlight.

Larry King

Diabetes just boggles me. I know when you get a heart pain; I’ve had them. I don’t know what diabetes feels like. … If someone had said to me, “What’s your No. 1 health problem?” I would have said heart disease and then diabetes. And what doctors tell me now is that I can transpose them and say diabetes first.

In this interview with Diabetes Forecast, longtime talk show host and diabetes advocate Larry King points to a very important topic: the relationship between heart health and diabetes. Often considered to be two distinct challenges, the reality is that diabetes and heart disease often go hand in hand. King shared, “My cardiologist said to me, diabetes is heart disease.”

Nick Jonas

“Diabetes sounds like you’re going to die when you hear it. I was immediately frightened. But once I got a better idea of what it was and that is was something I could manage myself, I was comforted.”

In his interview with fellow diabetic Larry King, Nick Jonas describes an experience with which many people with diabetes are familiar – confusion and panic at initial diagnosis, followed by a sense of security after some diabetes education. At No Cost Shoes, we have to tip our hats to diabetes management educators – they are so important to helping people like Nick understand the best way to manage diabetes day to day.

Later in the interview, Nick offers a glimpse of what diabetes management looks like to a touring musician. “I’ve had a few low blood sugars on stage,” he shared. “But, we have an amazing team when we’re on the road who are always prepared. I have juice on the side of the stage and my guitar tech will bring it out and make sure I’m cool. It’s just about knowing how to manage your specific diabetes, I feel like. Once you get a handle on it, it’s okay.”

Dr. Phil McGraw

“One thing that you really have to do is move forward. You’ve gotta really tackle this. You can’t be a passive patient.”

Dr. Phil is no stranger to giving advice, but the tips he offers on diabetes are a bit more personal than his other quips. After being diagnosed with Type 2 Diabetes over 25 years ago, McGraw became an advocate for healthy living and personal care. In this interview with TV show The Doctors, encourages fellow diabetics to take action with five steps, including get educated, get a team, and replace bad habits. Watch his story and advice for others here:

Mary Tyler Moore

(on insulin injections) “It’s just like sitting down to the make up table – I’ve got this I’m going to put on, have a drink of coffee, you know – it’s part of your routine.”

TV darling Mary Tyler Moore’s discussion of insulin may sound casual, but it’s clearly something she takes very seriously – enough to make several television appearances to discuss diabetes, including frank discussion of risks including blindness and amputation. This clip from a 2005 shows how her matter-of-fact approach helped her manage the diagnosis, which she received in 1969.

Tom Hanks

“Everybody’s going to have some degree of health problems, and as we get older I think we’ve gotta maintain.”

Tom Hanks’ revealed his diabetes in a 2013 interview on Letterman, where he lightheartedly poked fun at the diagnosis. In a follow-up interview, he clarified that although he handled the diagnosis well, self-care was a priority. “I know what I have to do. I have access to good doctors, I can eat good food, and after that it’s all up to the individual.”

Halle Berry

“People think it’s hard to cut out sugar, but it can be done. You just have to put some effort in.”

The always optimistic Halle Berry noted in an interview with Marie Claire that the diet required to manage her diabetes had actually contributed to a better quality of life for her whole family. “I’m healthier since the diagnosis,” She told the magazine. “And I think it has made me a better mom, because I’m so aware of how much sugar we consume. I’ve very conscious of what my children eat and how much they take in.”

Jay Cutler

In our profession, you’re supposed to be tough…I thought it was something I would just bounce back from.

This relateable quote from NFL star Jay Cutler explains the process many people go through when first diagnosed with diabetes, especially those expected to be “tough” and healthy for work like professional athletes. Today, Cutler is comfortable discussing the emotional side of diabetes as well as the physical challenges. “Sometimes I take pride in it, sometimes I feel bad for myself. There’s a whole range of emotions you go through.” Cutler reveals the challenges of being a diabetic pro athlete in a series of videos, which you can watch here:

Randy Jackson

[With diabetes] there are so many things that you learn that you didn’t think you wanted to know, but now you have this disease, you’ve gotta do it.

Award-winning producer and American Idol judge Randy Jackson received his diabetes diagnosis while filming the popular talent show. Even though his father had the disease and he admits he wasn’t eating right, it still came as a shock. Luckily, he quickly learned to rise to the occassion. “All your life you’ve heard the doctors say diet and exercise actually works, but as I look back on it I was never really doing it. I had to have major behaviour modification in every way.” After losing 110 pounds and taking control of his diabetes, Jackson is able to share valuable lessons from his journey in appearances such as this interview with The Doctors.

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Note: This article was written by No Cost Shoes, a leading diabetic shoe supplier that provides Medicare-covered therapeutic shoes, inserts, and medical aids to people across the United States. For more information on how to get what you need to manage diabetes at no cost to you, visit nocostshoes.com.

What Medicare Covers for Diabetics Dealing with Chronic Pain

Living with diabetes often involves more than just a change in diet and regular glucose testing. Diabetic individuals in the United States often experience a wide variety of complications that have a significant impact on daily life. One of the most impactful (and frequently misunderstood) issues that many people deal with is chronic pain, often caused by neuropathy.

Those who are experiencing chronic pain with diabetes often have several questions: How do I manage these pain issues while still living my life to the fullest? What treatment options are available to me? What does Medicare or my insurance company cover to treat?

We are here to help clarify how people with diabetes can use their Medicare coverage to live their best lives when faced with chronic nerve pain.

Why is chronic pain common in people with diabetes?

Chronic pain is defined as moderate to severe pain that is felt on a daily basis and continues for over six months. Statistically, people with diabetes are more susceptible to long-term pain than those without the diagnosis. Not all nerve pain has the same root cause, however. Here are some of the reasons a person with diabetes may be dealing with this issue:

Neuropathy. This is a common complication of diabetes that can include pain and numbness in the back, feet or hands.
Arthritis. Type 2 diabetes and arthritis both disproportionately affect people who are older, making the combination fairly common among aging Americans.
Fibromyalgia and pain conditions. While these conditions may not be directly linked to diabetes, chronic pain disorders combined with diabetic neuropathy can exacerbate the challenges people face.

What can I do to manage my chronic pain with diabetes?

Prescription medications are often the first thing discussed when it comes to treating chronic pain, but many different and non-drug treatment options can help support an effective treatment plan. Luckily, Medicare covers many of these things.

For a full list of items covered by Medicare for people with diabetes, click here.

1) Use a Transcutaneous Electrical Nerve Stimulator (TENS Therapy)

TENS therapy uses small electrical impulses to block pain signals and increase endorphins. It is recommended by many pain management professionals as a non-invasive, non-painful and non-surgical way to treat neuropathy and similar conditions.

Besides its effectiveness, this treatment is used by many people with chronic pain because it is easy to do from the comfort of home. The FREEDOM TENS Unit is a device that people can keep on hand to respond to pain flare-ups. It comes with four modes (Burst, Normal, Pulse Width Modulation, Pulse Rate Modulation) allow users to modify the treatment depending on what works for them.

How to get it a TENS unit covered by Medicare: Talk to your doctor to get a signed “durable medical equipment” prescription for a TENS unit. You will need to meet certain standards in order to be approved for coverage, including the verifying that the pain is chronic (3 months or longer). Medicare will typically cover a 30 to 60 day rental of the unit to start, then allow people to move onto a full purchase if the treatment is successful. For more information on the paperwork needed and how to rent or buy a TENS unit, contact Quantum Medical Supply at 1-866-923-2423.

2) Wear the right shoes and inserts.

If you are feeling chronic pain in your feet, ankles, legs or even hips, there is some relief available: Medicare covers one pair of therapeutic shoes and three pairs of inserts for qualifying people each year. Even if the pain has not reached your feet, diabetic shoes can play an important role in protecting from future damage.

How to get diabetic shoes and inserts covered by Medicare: To obtain coverage, your doctor will need to fill out both a Certificate of Medical Necessity and a Shoe Prescription. The shoe prescription can also come from a podiatrist or nurse practitioner. Your shoes will also need to be professionally fitted and ordered your shoes from a Medicare-approved supplier. Some, like nocostshoes.com, are even able to directly bill your insurance company. To see if you qualify, click here to fill out our application.

3) Get back, knee, ankle and/or wrist braces.

Braces are commonly recommended by doctors and physiotherapists to reduce pain from free-moving joints. There are specific types of braces that may be more beneficial for long-term use by someone with chronic pain; for example, this product from TemCare Pro uses an air pump system to help people customize the compression for added comfort.

How to get diabetic shoes and inserts covered by Medicare: Like shoe coverage, a certificate of medical necessity and qualifying diagnosis is needed to get coverage for these items. For more details on what is available and the documents needed for coverage, call 866-923-2423.

4) Control your blood sugar using a continuous glucose monitor (CGM).

Managing blood sugar should be at the top of your list if you’re dealing with any symptoms of diabetes, including chronic pain from neuropathy. Medicare covers various blood sugar/glucose testing aids including test strips, syringes, and insulin pumps. One of the most exciting and often lesser known things Medicare covers for glucose management is a continuous glucose monitor or CGM.

Continuous glucose monitors like the Dexcom G6 are an easy-to-use alternative to a finger prick blood sugar test. Using a small sensor placed below the skin, it keeps an eye on glucose on an ongoing basis. This can improve the accuracy of readings and remove the discomfort of a traditional test. Best of all, this technology is free or deeply subsidized for people with Medicare and certain insurance plans!

Just 2 weeks of inactivity can trigger Type 2 Diabetes, study finds

Does staying active matter when it comes to preventing type 2 diabetes? According to recent research, the answer is a resounding YES – in fact, movement might be even more critical for prediabetics than previously thought.

The new study measured the impact of 2 weeks of inactivity had on older adults with prediabetes. Here is what they found in people who were inactive for two weeks:

Their skeletal muscle mass and strength significantly decreased;
They started showing insulin resistance, a sign of type 2 diabetes;
The damage appeared to be permanent – after going back to a more active lifestyle, participants did not return to the way they were beforehand.

The last point is particularly interesting. It suggests that it may be impossible for some seniors to return to a healthy state following a period of inactivity.

What considered a dangerous level of “inactivity” for prediabetics?

In this study, “inactivity” was defined as less than 1,000 steps per day. This reflects the activity level of a person classified as “homebound”. According to other studies, 39 percent of homebound seniors have diabetes compared to 11.4 percent of their more active and social counterparts.

Previous research has shown that healthy older adults walk between 2,000 and 9,000 steps per day. The average number of steps for a person of any age in the United States is 4,774.

How to manage diabetes and prediabetes with exercise

When people talk about managing prediabetes and type 2 diabetes, diet is typically the first thing that comes up. There is no doubt that diet is a crucial risk factor for type 2 diabetes, but this study shows that we may have been underestimating the importance of physical activity. Here are a few tips to make sure you’re moving enough each day:

Keep it simple. You don’t need a fancy gym membership or an extensive exercise regimen to move more each day. Go for a daily walk, play with grandchildren, or do some yard work to keep active. While fitness classes and treadmills are great for filling in the gaps and staying active during bad weather, you don’t need to change your life dramatically in order to move enough each day.
Talk to your doctor about your exercise plan. Going from no activity to an intensive exercise program can hurt your body instead of helping it. Discussing your lifestyle with a doctor will help you stay conscious of your blood pressure, heart rate and the sensitivity of joints and muscles.
Stay motivated. Pedometers or “step counters” are great ways to track your progress and motivate yourself.
Make it social. 30 million Americans have diabetes and 84 million have prediabetes, so chances are you can find a neighbor, family member or friend who could also benefit from physical activity. You can also attend group workouts or find local walking and hiking groups to join.
Stay hydrated and watch your blood sugar. Don’t neglect other aspects of your health, like hydration and diet! Bringing a water bottle and light, diabetes-friendly snack on your walks.

Protecting your feet as you exercise

Those who do have diabetes should also consider the health of their feet when taking on an exercise plan. Due to circulation issues and neuropathy, even a small blister can have serious long-term consequences for people with diabetes. For this reason, Medicare covers one pair of diabetic shoes and two pairs of therapeutic inserts per year for people who have diabetes and foot issues.

If you are receiving Medicare or other insurance support for type 2 diabetes and would like more information about diabetic shoe coverage, our team at nocostshoes.com would love to help you out! Click here to order our catalog or call us at 1-866-923-2423 for more information.

Nurse practitioners, physician assistants could sign off on therapeutic shoes under new bill

Medicare covers one pair of therapeutic shoes and two inserts for many people with diabetes each year. However, a doctor’s prescription is currently required to confirm coverage. A new bipartisan bill, the Promoting Access to Diabetic Shoes Act, could make it possible for nurse practitioners and physician assistants to also sign off on these prescriptions. Supporters hope this will help more people with diabetes access much-needed therapeutic shoes to prevent complications such as foot ulcers and calluses.

Nurse Practitioner at Canberra Hospital Walk-in Centre

Foot issues are a major concern for people with diabetes. That’s why Medicare and most major insurance companies cover the cost of custom-made diabetic shoes and inserts.

It sounds pretty great – but there’s a catch. To access coverage for these shoes, people need to go through a series of steps. This includes getting a prescription from a doctor and being professionally fitted for shoes.

While the shoe fitting remains critically important for a foot’s health, the prescription requirement has received some pushback. Not everyone who needs these therapeutic shoes has access to a doctor on a regular basis. Particularly in rural and underserved areas, many diabetics depending on nurse practitioners and physician assistants for regular health care support.

Two U.S. Senators, Maine Republican Sen. Susan Collins and Ohio Democratic Sen. Sherrod Brown, have decided to take action on this issue. They have introduced a bill entitled the Promoting Access to Diabetic Shoes Act.

The goals of this proposed legislation are:

Reduce cost for patients and/or insurance companies: Many patients incur expenses trying to get routine prescriptions for diabetic shoes from their doctors. By allowing more medical professionals to sign off for shoes and inserts, they will avoid these expenses.
Save patients and doctors time: Patients who wear therapeutic shoes often need a new prescription each year in order to get coverage from Medicare or insurance. This will cut out the annual back-and-forth by allowing an NP or assistant to provide the needed renewal. It will also help people who need therapeutic shoes to get them more quickly.
Increased access to therapeutic shoes: People in underserved or rural areas may not have access to a doctor. This bill would allow them to still access the shoes they need.
Encouraging use of therapeutic shoes for those who need them: By getting rid of some of the red tape, the bill aims to encourage those who truly need these shoes to go ahead and get them. Not using the correct shoes can lead to serious foot complications and loss of limbs for many diabetics, so this is a critical preventative tool for people trying to take care of themselves.

As L. Gail Curtis, MPAS, PA-C, DFAAPA, president and chair of the American Academy of Physician’s Assistants’ Board of Directors notes, “With the aging population and the increasing prevalence of this disease, removal of this barrier will make such a difference for patients everywhere. AAPA appreciates Senators Collins and Brown for introducing this common sense legislation.” The bill has also been endorsed by the American Association of Nurse Practitioners and the American Podiatric Medical Association.

More than 100 million adults in the United States are now living with diabetes or prediabetes. At No Cost Shoes, we work to connect these people with therapeutic shoes covered by Medicare. We try to make this as easy as possible by faxing a prescription to a family doctor to sign, but many still find that accessing a doctor is a challenge. For example, some patients do not have a family doctor, while others struggle to afford prescription renewal fees from an MD’s office.

As always, we will continue to keep you updated on any new and legislation that may affect your access to diabetic shoes and inserts. Those seeking support in accessing diabetic shoes can check their eligibility for coverage at nocostshoes.com.