Diabetics skimp on care as economy slides

Diabetics are increasingly risking life and limb by cutting back on —- or even going without —- doctor visits, insulin, medicines and blood-sugar testing as they lose income and health insurance in the recession.

Doctors report a drop in regular appointments with diabetic patients, if they come back at all. Patients more often seek tax-subsidized or charity care. And they end up in emergency rooms more often, patients and physicians say.

Sales of drugs and other products used to treat and monitor the disease have dropped since the economic crisis accelerated last fall. Meanwhile, the number of people with the disease keeps growing —- an additional 1.6 million Americans were diagnosed in 2007 alone.

Diabetics who don’t closely monitor and control the chronic disease risk particularly dire complications: amputations, vision loss, stroke —- even death.

Dr. Steven Edelman, a University of California, San Diego, endocrinologist who runs a free clinic staffed by medical students, said he has seen a 30 percent surge the past six months in patients seeking free diabetes medicines and supplies. “A third to a half of these people haven’t been taking their meds at all,” he said.

By February, sales of most categories of diabetes pills and insulins were down from a year earlier, most by double digits, figures from the health data firm IMS Health Inc. show. “By December, people were making decisions in terms of, ‘Do I fill this prescription or … buy Christmas presents for my kids?’” said Brian Lasky, a research analyst at IMS Health.

April Bumpus, 31, of Woodstock, was laid off from her job in medical sales last spring and her health insurance was canceled. By September, she had to switch from two advanced insulins that tightly controlled her blood sugar to cheaper, older ones that cause surges and drops.

“It makes you really feel like you have the flu” at least once a week, said Bumpus, who’s more worried about the long-term consequences. “I can have a heart attack, I can have a stroke, I can go blind.”

Emergency rooms increasingly are treating diabetics who haven’t been taking medicines, according to an ER doctors’ professional group.

Dr. Nicholas Vasquez, who works in one of the country’s biggest ERs, at St. Joseph’s Hospital in Phoenix, and his colleagues view the desperate patients in their ERs as harbingers of what’s to come if the recession deepens.

“What we’re seeing mostly is the first steps of people not taking care of their diabetes and starting to have consequences,” he said.