The Challenges of Managing Diabetes

Posted on Thursday, November 4, 2021

November is National Diabetes Month—a time when communities across the nation come together to call attention to the diabetes epidemic. Over the last 20 years, the number of adults diagnosed with the disease more than doubled as the population has aged and become more overweight or obese. In fact, diabetes is the 7th leading cause of death in the U.S. and may be underreported, according to the Centers for Disease Control and Prevention.

Today, more than 34 million Americans have diabetes; 1 in 5 don’t know they have it. More than 88 million Americans have prediabetes; more than 84% are unaware they have it. And without intervention, many with prediabetes could develop type 2 diabetes within five years.

Like many chronic diseases, managing diabetes is demanding. People with the disease must deal with various issues, like blood sugar level, diet, and a complex medication regimen. Fortunately, diabetes is manageable—but it requires a lifelong commitment to making the right choices.

Below are four key challenges to managing diabetes.

1. Cost

Treating diabetes is expensive—the disease progresses and requires continuous intervention. On average, people with diabetes have medical expenditures about 2.3 times higher than those who don’t have the disease.

For the average insulin patient who has insurance, the price of living with diabetes can exceed $4,800 per year. Actual out-of-pocket costs vary, though, based on insurance status, the severity of the disease, and even having other chronic conditions. People with diabetes who don’t have insurance can spend an additional $1,300 in annual expenses (a whopping $6,100!) to control their diabetes.

Sadly, some people with diabetes are forced to choose between insulin or putting food on the table as insulin prices soar. In the past decade, out-of-pocket costs for insulin doubled. According to the American Academy of Family Physicians, many people with diabetes need at least two insulin shots a day, and others need more.

A Yale University survey found 1 in 4 individuals with type one diabetes ration their insulin because they can't afford it. Over one-third said they never discussed this with their provider.

2. Self-monitoring

Self-monitoring blood glucose is integral to diabetes self-care, as it provides immediate feedback and data that enable people with diabetes to assess how their food choices, physical activity levels, and medications affect their blood glucose control.

People with type 1 diabetes usually need to measure their blood glucose levels at least four times daily. Those with type 2 diabetes who take insulin or other diabetes medications need to regularly measure their glucose levels, as recommended by their health care provider.

For some people, however, self-monitoring can be frustrating. They may not be fully educated on how to interpret their test results to properly manage their condition. Perhaps they lack the motivation to test or find regular testing cumbersome. Some people feel physical pain in pricking their fingers. Expensive testing supplies, as well as access to supplies, can be other barriers to self-monitoring.

3. Medication Adherence

Medication adherence is the extent to which patients take medication as prescribed by their doctor. For people with diabetes, medication adherence is critical for disease management. Ultimately, it can lead to lower per-patient costs and is linked to positive clinical outcomes. Yet, the American Association of Diabetes Educators reports that half of people with a chronic disease like diabetes don’t take their medications as prescribed.

Non-adherence leads to increased morbidity and mortality and is also associated with a greater risk of a significant adverse cardiac event. The total healthcare cost-related adherence is estimated $317 billion annually.

The two most common reasons for non-adherence are forgetfulness and lack of perceived benefit. Fear of injection can also be a barrier for people who use insulin. Cost is another issue, resulting in some patients not filling their prescriptions.

4. Healthy Lifestyle

Changes in lifestyle and dietary patterns are essential to successfully managing diabetes. Lifestyle modifications include regular physical exercise, weight management, and diet control help to mitigate the long-term effects of diabetes.

Unfortunately, long-term effects—like cardiovascular disease, nerve damage, kidney damage, eye damage, skin conditions, hearing impairment, and more—may not be visible until later. This causes some people with diabetes to ignore the importance of getting the proper nutrition and recommended exercise.

Health literacy can also play a role. Health literacy is “the degree to which individuals can obtain, process, and understand basic health information and services needed to make appropriate health decisions. Many people with diabetes have low health literacy, limiting their ability to understand and implement self-management behaviors required to manage their condition. Research shows that low health literacy is more common among older patients with limited education, lower income, chronic conditions, and non-native English speakers.

Food insecurity can also be a barrier to leading a healthy lifestyle. Research shows food insecurity in all its forms is a significant risk factor for type 2 diabetes. Many people who are food insecure consume empty calories that offer minimal nutrition. Contributing reasons may include a limited budget, difficulty holding down a job due to diabetes complications, or choosing between meals or medication to control their diabetes.


To fulfill the nutritional needs of people with diabetes, Mom’s Meals offers fully-prepared meals that are low in carbohydrates, which is essential to maintaining good blood sugar control.

Click here to download our latest white paper, “In the Balance: Managing Diabetes Through Nutrition."

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