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According to Daly et al, a survey of patients suggested that the most common barrier to self-care is cost, including expenses for following the recommended meal plan, medications, blood glucose monitoring, and exercising. High co-pays and deductibles, lack of adequate insurance, no insurance, and limited economic resources can lead to patients prioritizing and choosing to pay only for those therapies they see as immediately impacting their quality of life, such as symptoms. Meanwhile, the intangible benefits of controlling blood sugars may be neglected and lead to progression of the disease that will further lead to a reduction in quality of life and other complications.

The Standards of Medical Care in Diabetes published by the American Diabetes Association recommends reimbursement for medical nutrition therapy and Diabetes Self-Management Education. When specific criteria is met, as delineated by the Centers for Medicare and Medicaid Services, these features of patient support are reimbursable through Medicare programs.

Social workers that are members of the health care team can assist with referrals for medication assistance programs, applications for public assistance programs, and working toward other economic assistance that can free up funding for medications and other therapy costs. In some cases, free services and other resources may be available in a community setting. Support groups can also help to identify local resources that may be helpful to reduce economic barriers to adherence. The National Diabetes Information Clearinghouse has a number of links to resources for economic support.


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