Study Evaluates Financial Implications, Socioeconomic Profile of Patients With Diabetes

New study findings published in JAMA Network Open demonstrate that individuals with type 2 diabetes (T2D) had significantly worse financial outcomes compared to individuals without diabetes. Determined by 7 financial outcomes that were studied, individuals with T2D were more likely to have below-prime credit scores, medical and non-medical debt in collections, 60-plus-day debt, debt charge-offs, bankruptcy filings, and foreclosure, emphasizing a greater financial burden compared to other patients.^1,2

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“Our data point to substantial financial hardships for patients with type 2 diabetes and help explain why so many ration medicine and don’t follow the health care recommendations that could help them control their disease,” Joshua Joseph, co-author and associate professor of endocrinology, diabetes, and metabolism at Ohio State, said in a news release.²

Diabetes and Financial Strain

Diabetes significantly impacts financial well-being, with 20% to 25% of adults rationing insulin and 30% rationing other supplies, according to study authors. This leads to medication nonadherence, increasing risks of delayed medical care, food insecurity, hospitalizations, and mortality. Although the financial burdens are known, their specific impact on financial outcomes is not widely understood. To further assess these financial outcomes, researchers conducted a study that aimed to link patient electronic health records with commercial credit and government age data for over 4 years. The study authors noted that this research will also explore the relationship between the prevalence of T2D and financial indicators.^1,2

Greater Financial Burden in Patients With T2D

In the economic evaluation study, researchers analyzed electronic health records linked to credit records and employment information of adults aged 18 years or older with at least 1 medical encounter at a primary care health center in Ohio between October 1, 2017, and December 31, 2021. To be included in the analysis, individuals needed a reported glycated hemoglobin (HbA_1c) value, a diagnostic code for T2D, or a prescription for antidiabetic medications.¹

A total of 166,285 patient data were used in the study, with a mean age of 52.3 years, with 55.0% being female and 45.0% male. The racial breakdown was 0.2% American Indian/Alaska Native/Native Hawaiian/Pacific Islander, 3.5% Asian, 19.1% Black, and 73.2% White, with 0.8% identifying as multiracial. Of the total participants, 69,371 had a diagnosis of T2D.^1,2

To determine the financial burden, researchers compared the 41.7% of individuals with T2D to individuals without diabetes that was determined through a blood test. In the analyzed group, 50.8% had no earned income, and 32.6% were covered by Medicare. Individuals with diabetes were, on average, older and less frequently female or of Hispanic ethnicity. However, a higher percentage of individuals with diabetes were Black race. Additionally, individuals with diabetes were also more likely to have no wage earnings at baseline (65.1% vs 40.6%), and for those who did have earnings, the average earnings were lower ($11,477 vs $15,400).^1,2

“Finances are a major challenge for many of the patients I treat, so much so that we are asking them questions around what we call the social determinants of health in our patient visits,” Joseph said in a news release.²

The findings suggest that individuals with T2D may experience more adverse financial outcomes compared with individuals without diabetes, highlighting the need for pharmacists and health care providers to consider when treating individuals with T2D.^1,2

“Our results really speak to the importance of screening diabetes patients for finances and debt issues,” Joseph said in the news release. “But beyond screening, we also need to ensure they have access to resources in the community that can help them to ultimately improve their financial situations. It is critical for their health and well-being.”

REFERENCES

1. Pesavento M, Loibl C, Moulton S, et al. Type 2 Diabetes and Financial Outcomes. JAMA Netw Open. 2025;8(7):e2523453. doi:10.1001/jamanetworkopen.2025.23453

2. A financial toll on patients with type 2 diabetes. EuerkAlert!. News release. July 28, 2025. Accessed July 29, 2025. https://www.eurekalert.org/news-releases/1092484