As West Virginia starts to ease coronavirus-related restrictions, the state’s many residents with diabetes or pre-diabetes will have to navigate the transition with caution.
The Centers for Disease Control and Prevention says those at higher risk of severe illness from covid-19 include people 65 and older, people who live in a nursing home or long-term care facility, people with chronic lung disease or severe asthma, people who have severe heart conditions, people who are immunocompromised, people with severe obesity and people with diabetes.
“Any of these chronic diseases, your immune system is compromised. When any disease and infection hits, your body and your body’s ability to fight that infection or disease — it’s harder to do that,” said Tracey Brown, chief executive of the American Diabetes Association.
West Virginia has many residents who fit each of those categories.
Diabetes is particularly prevalent.
The state Department of Health and Human Resources describes the rate of diabetes as an epidemic in West Virginia.
Fifteen percent of West Virginia adults has diabetes, according to DHHR. That ranked West Virginia at the top of the nation.
About 11 percent of West Virginia adults had pre-diabetes, according to DHHR.
The American Diabetes Association shows an even higher prevalence of those with pre-diabetes, 35 percent.
Serious complications from diabetes include heart disease, stroke, the necessity of amputation, blindness or death.
“You can imagine that the correlation between diabetes and any underlying condition as it relates to covid-19,” Brown said last week in an interview with MetroNews.
“Everybody has the same risk factor for contracting covid-19 but when somebody with diabetes or an underlying condition contracts covid-19 there is a much higher likelihood of a poor outcome.”
Brown and the American Diabetes Association sent a letter to Gov. Jim Justice asking for policies meant to help diabetics deal with the pandemic.
The letter expresses concern about the thousands of people who have experienced a job loss, which has also meant the loss of health insurance.
“This is especially problematic for Americans living with diabetes who could now face significant out-of-pocket costs obtaining prescription medications and supplies, including insulin, and who are already among the most vulnerable to the pandemic due to their compromised immunity.”
The American Diabetes Association notes that during the past legislative session, officials placed a cap on insulin copayments at $100 for a 30-day supply.
During the pandemic response, the ADA recommends going a step farther to eliminate the copay, allowing it to resume when the crisis passes.
“The last thing we want is for people to skip their medicines or ration their insulin, which puts them at greater risk of ending up in the hospital or ending up with bad health outcomes,” Brown said. “That’s one small thing that every state could do.”
The ADA is also pushing for people who lose their jobs to be automatically enrolled in Medicaid and prohibiting their removal if they fail to pay or are late in paying premiums.
“Not only do you have all of the things we should be doing, sheltering at home, social distancing, what you have on top of this now are businesses closing, furloughing people, laying people off,” Brown said.
“Many people have lost their health insurance. Their income has been greatly reduced. The medical expenses for a person living with diabetes is almost two and a half times higher than the people without diabetes.”
Even before this, the medical costs of diabetes were enormous.
The American Diabetes Association estimates the costs of diabetes and pre-diabetes at $2.5 billion in West Virginia each year. That includes direct medical expenses as well as an estimate of indirect costs of lost productivity because of diabetes complications.
“It is much better to keep people managing their diabetes – that is so much better than going to the place of unmanaged where you hit complications and end up in the hospital. That’s a much worse decision and choice,” Brown said.
“This diabetes epidemic was truly an epidemic well before covid 19. What covid-19 is doing is shining a light on an epidemic that already should have been dealt with.”