Complications from the secondary symptoms of diabetes generate more than half of the costs associated with diabetes, including inpatient and emergency medical services. But their onset can be largely delayed until later in life if patients maintain their A1C levels through proper diet, regular exercise, and access to adequate and affordable healthcare and medications. Patients who receive quarterly A1C tests, as well as annual tests for neuropathy and retinopathy, are more likely to better maintain their diabetes. By having personal information about the status of their disease periodically, patients can better adjust diet and exercise, and their physician can recalibrate medications as needed.

Private insurance and Medicare are more likely to provide these tests, as opposed to Medicaid or Tricare/Champs VA. Private insurance was positively correlated with receiving neuropathy and retinopathy tests for both Type 1 and Type 2 diabetics, and Medicare was positively correlated with A1C tests for Type 2 diabetics in a regression statistics study using 2009 Medical Expenditure Panel Survey data. However, there is room for improvement. By providing a few consistent and inexpensive tests, diabetes costs can be reduced for individuals, healthcare providers and the economy.

The impoverished have had less access to healthcare, which makes them more vulnerable to develop diabetes, as well as secondary symptoms of the disease. As Congress works to make improvements on the Patient Protection and Affordable Care Act of 2010, they should preserve and expand Medicare and reduce the costs of prescriptions for all. With fewer barriers to entry, patients will be more likely to receive care and take medications as prescribed to manage the disease, and thus reduce costs overall.