Managing Diabetes Costs in Faisalabad

Diabetes mellitus (DM) is one of the most common and financially demanding health issues affecting people worldwide. For people in Faisalabad, Pakistan, managing this condition brings significant economic challenges. This article explores the direct and indirect costs of diabetes, along with the importance of self-care practices in controlling it, based on a recent study. Through detailed analysis, this article provides insight into how diabetes impacts individuals and society and what strategies may ease its financial load.

Understanding the Cost of Diabetes in Faisalabad

A recent study conducted in Faisalabad between April and May 2024 aimed to assess the total cost of managing diabetes, covering both direct and indirect expenses. Researchers collected data via an online questionnaire distributed to patients. The responses helped determine the average monthly costs and highlighted other factors, such as education, income, and age, that influence these costs.

In the study, direct costs refer to the money patients spend on medications, doctor visits, and other medical supplies, while indirect costs capture income lost due to time off work or reduced productivity caused by the illness. These economic burdens vary significantly among different groups, largely depending on factors such as age, education level, and whether patients have additional health issues (co-morbidities).

Monthly Costs by Patient Characteristics

1. Older Age, Higher Cost: The study found that older individuals incur higher monthly expenses for diabetes care, with costs averaging around PKR 13,861 (about $50) for those aged 60 or above. Patients who have been living with diabetes for over a decade experience slightly higher costs, averaging PKR 14,411 (around $52).

2. Impact of Education: Education levels play a key role in how much patients spend. Individuals with lower education levels often face higher expenses, averaging around PKR 22,200 ($80). With less understanding of diabetes management, these patients tend to require more frequent medical assistance.

3. Income and Healthcare Spending: The study found that individuals earning above PKR 97,000 (approximately $360) per month spend an average of PKR 16,750 ($62) on diabetes care. Higher-income individuals tend to seek more comprehensive healthcare, which leads to increased spending.

4. Costs Due to Co-Morbidities: Patients with additional health conditions like heart disease, dyslipidemia (an abnormal amount of lipids in the blood), retinopathy (eye disease), or nephropathy (kidney disease) face even higher costs. The average costs for those with these co-morbidities range from PKR 17,000 ($63) to PKR 23,300 ($85) per month.

These findings show that managing diabetes in Faisalabad requires substantial spending, particularly for older individuals, those with lower literacy levels, and those with additional health issues.

The Role of Self-Care in Reducing Diabetes Costs

An essential aspect of diabetes management is self-care, which includes practices such as regular exercise, healthy eating, and frequent blood glucose monitoring. The study highlighted the significant impact of self-care behaviors, especially exercise, on glucose control.

Regular physical activity—such as a 30-minute daily walk—was found to have a major effect on blood glucose levels. Regression analysis in the study showed that 87.4% of glucose reduction could be attributed to exercise. This finding stresses the value of self-care, especially for those struggling to manage diabetes-related expenses. By adopting better self-care habits, individuals could potentially reduce their overall costs.

Social and Economic Factors Affecting Diabetes Management in Faisalabad

The study also shed light on social factors that influence the management of diabetes:

1. Gender and Diabetes Prevalence: The study found a high percentage of male respondents (80.9%), consistent with global data suggesting more men than women have diabetes. This trend may be due to lifestyle factors and eating habits common among men in Faisalabad.

2. Marital Status: Married individuals showed a higher likelihood of having diabetes, with nearly 95% of participants being married. Previous research indicates that married individuals are at a higher risk of diabetes due to shared lifestyle factors, such as eating habits and exercise routines, or the stress of marital challenges.

3. Education and Health Literacy: Although 98% of the study’s participants had some form of education, most of them had only elementary-level schooling. Limited education often leads to a lack of understanding about diabetes management, which results in higher expenses. In contrast, individuals with higher education levels tend to manage diabetes more effectively, with better self-care practices and lower healthcare costs.

4. Employment Status: The economic burden of diabetes is also linked to employment status. In Faisalabad, 33% of respondents worked in the private sector, while a significant portion (23.4%) was unemployed, and 19.1% worked as laborers. Those in lower-income or informal jobs often face higher financial strain in managing diabetes due to fewer resources and lack of access to comprehensive healthcare.

Impact of Co-Morbidities on Diabetes Costs

Managing diabetes becomes even more complicated and expensive when combined with other health issues. In this study, hypertension was the most prevalent co-morbidity, affecting over 70% of patients, which echoes findings from other studies worldwide. Similarly, dyslipidemia was present in about 37% of patients, significantly increasing the cost of diabetes care.

The study also found that about 36% of patients had depression or heart disease, while nearly 26% suffered from retinopathy, an eye condition that requires costly treatments to prevent vision loss. Other complications included neuropathy (nerve damage) and nephropathy (kidney disease), which, although less common, still contribute to increased healthcare expenses.

For patients with these additional conditions, monthly diabetes care costs rose to an average of PKR 17,000 to PKR 23,300 ($63 to $85). The presence of these co-morbidities not only adds financial strain but also increases the complexity of diabetes management, making effective self-care and early medical intervention even more critical.

Monthly Costs by Demographic and Clinical Factors

The study reveals significant variations in monthly diabetes care expenses based on different patient factors:

1. Age Factor: Older patients (aged 60 or above) have the highest monthly costs, around PKR 13,861.

2. Disease Duration: For patients living with diabetes for more than 10 years, costs are approximately PKR 14,411, reflecting the cumulative burden of long-term management.

3. Education Impact: Patients with limited literacy experience higher costs, reaching PKR 22,200 monthly.

4. Income and Healthcare Spending: Higher-income patients generally spend more, averaging PKR 16,750 per month on care.

5. Co-Morbidities: Conditions like dyslipidemia, heart disease, retinopathy, and nephropathy significantly drive up monthly costs, making management difficult for patients with limited financial resources.

These variations highlight the importance of targeted health policies and support for diabetic patients, especially those with limited education or additional health issues.

Lessons and Policy Implications for Managing Diabetes

The findings of this study offer valuable insights for healthcare policymakers. Understanding the financial burden of diabetes in Faisalabad can help guide resource allocation and healthcare planning. By focusing on strategies to reduce the costs of diabetes care, policymakers can better support individuals and families impacted by this chronic disease.

Policies encouraging regular self-care and exercise could also have a major impact on reducing diabetes management costs. Furthermore, awareness campaigns and educational programs are essential for improving health literacy among diabetic patients, especially those with limited education. By fostering better knowledge about self-care practices, these programs could reduce the financial strain of diabetes over time.

Finally, ensuring access to affordable healthcare services for lower-income groups and patients with multiple health issues is vital. Increased funding for diabetes management, as well as preventive and support services, can help alleviate the economic burden on individuals and their families.

Conclusion

Managing diabetes in Faisalabad is a substantial financial challenge, with direct and indirect costs heavily influenced by factors such as age, education level, income, and the presence of co-morbidities. As the study reveals, older patients, those with lower literacy, and individuals with other health complications face the highest costs. Regular exercise and other self-care practices can significantly aid in glucose control, offering a cost-effective way to manage the disease.

The financial demands of diabetes not only affect individuals but also places a burden on families, healthcare systems, and the economy. Addressing these issues through targeted policies, education, and preventive measures can help reduce diabetes-related costs and improve the quality of life for diabetic patients in Faisalabad. With these steps, Pakistan can move closer to a future where diabetes is managed efficiently and affordably.

Please note that the views expressed in this article are of the author and do not necessarily reflect the views or policies of any organization.

Ayesha Sonia holds MPhil Economics degree, and Muhammad Khalid Bashir is serves as an Associate Professor at the Institute of Agricultural and Resource Economics and as a Co-Chair in the Policy, Advocacy and Outreach of the Pak-Korea Nutrition Center (PKNS) project at the University of Agriculture, Faisalabad, Pakistan.

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