Study to help reduce risk of heart disease and diabetes, to be done via Zoom, is looking for participants in 16 Kentucky counties

Kentucky Health News map

By Gia Mudd-Martin

University of Kentucky

Heart disease and Type 2 diabetes are often preventable, but Kentucky has the nation’s ninth-highest rate of heart disease and the fifth highest rate of diabetes. Plus, many Kentuckians have pre-diabetes but don’t know they have it.

A team of at the University of Kentucky is leading a health study called “Heart of the Family” to help people learn to reduce their risk for these illnesses, and the team is inviting participants to join.

What do participants get?  

• “Heart of the Family” participants receive eight one-on-one, personalized health education sessions based on their risk factors and health. The sessions are over Zoom — no travel required.
• Free screenings to check health measurements such as blood pressure and cholesterol; these can be done in your home community (team members can come to you) or at an off-campus UK office
• Gift card for participation

Who can join? You may be eligible to participate if you are:

• At least 18 years old
• Do not have heart disease or diabetes
• Live in one of these Kentucky counties: Anderson, Bourbon, Boyle, Casey, Clark, Franklin, Garrard, Harrison, Jessamine, Lincoln, Madison, Marion, Mercer, Pulaski, Scott, Woodford
• Have two or more of these risk factors: family history of heart disease or diabetes; personal history of gestational diabetes or polycystic ovarian syndrome; little or no exercise; unhealthy diet; high blood pressure; high cholesterol; elevated blood sugar; stress; depression; overweight; cigarette smoker

Some participants will be invited to have a friend or family member join with them as a “study buddy,” so make sure you have someone willing to participate with you. They can participate even if they have diabetes or heart disease. Study buddies will receive the same benefits listed above.

What is required of participants? Participants should be willing to complete eight virtual health-education sessions, share health information with the study team, and have blood drawn. All your information will be kept completely confidential, just like in regular medical care.

How can I get involved? If you’re interested in learning more or joining, contact Emily Cravens at emcravens@uky.edu or 859-218-6827. Learn more about participating in research at UKClinicalResearch.com.

Men's Health Month a reminder to schedule preventive screenings

By Melissa Patrick
Kentucky Health News

Men's Health Month in June is a reminder for men to think about their health and consider making some screening appointments that could lengthen, or even save, their lives. 

Why is it so important for men to take care of themselves? For one thing, on average in the United States, men die nearly six years earlier than women. 

That is a wider gap than before the pandemic, which took a disproportionate toll on men. Researchers also note that men are more prone to unintentional injuries, such as drug overdoses and  accidents. Homicides, heart disease and suicides also contribute to the worsening life expectancy for men. 

Men's Health Month is a time for men to take charge of their health and to schedule their preventive  health screenings, especially for the conditions that if caught and treated early could save their life. 

Some recommended screenings include: 

 

Heart disease is the leading cause of death in men, according to the Centers for Disease Control and Prevention.  The American Heart Association says the key screenings for heart health involve an annual physical that include test for blood pressure, cholesterol, body weight and diabetes. Smoking is also a major cause of heart disease, and a health-care provider can help with a cessation plan. 

Skin cancer: Increased sun exposure and fewer trips to the doctor put men at a higher risk of developing skin cancer, so it's important to not only protect your skin when outdoors, but to see a dermatologist if you notice any change in a mole's color or appearance, or if they bleed, ooze, itch, appear scaly or become tender or painful. A dermatologist can also do a full-body skin cancer screening. 

Lung cancer: Kentucky still has one of the highest smoking rates in the nation and leads the nation in lung-cancer cases and deaths. Lung-cancer screening via low-dose computed tomography (a low-dose CT scan) is recommended for anyone 50 to 80 who smokes or has quit in the past 15 years and has at least a 20 pack-year smoking history (a pack per day for 20 years or two packs per day for 10 years). 

Prostate cancer: On average, one in eight men will be diagnosed with prostate cancer and it is the second leading cause of death among men, according to the American Cancer Society. It is recommended that prostate cancer screenings for men who are at average risk begin at age 50. 

Colon cancer: Routine screening for colorectal cancer is recommended to start at age 45. Men with a family history of the cancer may be advised to get screened earlier.

Diabetes: In Kentucky, about 100,000 people have diabetes and don't know it. That's why it's important to get screened with a blood test even when you don't think you have any symptoms.

Mental health: A primary-care provider is a good place to start if you are seeking help with a mental-health concern. Mental Health America of Kentucky also offers a free, online mental-health screening. The new, national 988 suicide/crisis hotline is available 24/7.

"While men are diagnosed with depression half as often as women and are less likely to attempt suicide, men die by suicide three to four times more frequently," says a peer-reviewed article in the American Medical Association Journal of Ethics by Nathan Swetlitz. "Although there is no one-to-one correspondence between depression and suicide, depression is one of suicide’s most significant risk factors."

High cost of new diabetes drugs, more popular in Ky. than any other state, deprives low-income people of effective treatment

Photo by George Frey, Bloomberg, via iStock/Getty Images, KFF Health News

Editor's note: At the end of 2023 Kentucky led the nation in the percentage of state population, 2.1%, who had received the new class of diabetes and weight-loss drugs.

By Renuka Rayasam
KFF Health News

For the past year and a half, Tandra Cooper Harris and her husband, Marcus, who both have diabetes, have struggled to fill prescriptions for medications they need to control their blood sugar.

Without Ozempic or a similar drug, Cooper Harris suffers blackouts, becomes too tired to watch her grandchildren, and struggles to earn extra money braiding hair. Marcus Harris, who works as a Waffle House cook, needs Trulicity to keep his legs and feet from swelling and bruising.

The couple’s doctor has tried prescribing similar drugs, which mimic a hormone that suppresses appetite and controls blood sugar by boosting insulin production, but those are also often out of stock. Even if they are available, their Affordable Care Act insurance burdens the couple with a lengthy approval process or an out-of-pocket cost they can’t afford.

“It’s like, I’m having to jump through hoops to live,” said Cooper Harris, 46, a resident of Covington, Georgia, east of Atlanta.

Supply shortages and insurance hurdles for this powerful class of drugs, called GLP-1 agonists, have left many people who are suffering from diabetes and obesity without the medicines they need to stay healthy.

One root of the problem is the high prices set by drugmakers. About 54% of adults who had taken a GLP-1 drug, including those with insurance, said the cost was “difficult” to afford, according to KFF poll results released this month. Patients with the lowest disposable incomes who are hit the hardest; they have few resources and often struggle to see doctors and buy healthy foods.

In the United States, Novo Nordisk charges about $1,000 for a month’s supply of Ozempic, and Eli Lilly charges a similar amount for Mounjaro. Prices for a month’s supply of different GLP-1 drugs range from $936 to $1,349 before insurance coverage, according to the Peterson-KFF Health System Tracker. Medicare spending for three popular diabetes and weight loss drugs — Ozempic, Rybelsus, and Mounjaro — reached $5.7 billion in 2022, up from $57 million in 2018, according to research by KFF.

The “outrageously high” price has “the potential to bankrupt Medicare, Medicaid, and our entire health care system,” Sen. Bernie Sanders (I-Vt.), who chairs the U.S. Senate Committee on Health, Education, Labor and Pensions, told Novo Nordisk in April.

The high prices also mean that not everyone who needs the drugs can get them. “They’re kind of disadvantaged in multiple ways already and this is just one more way,” said Wedad Rahman, an endocrinologist with Piedmont Healthcare in Conyers, Georgia. Many of Rahman’s patients, including Cooper Harris, are underserved, have high-deductible health plans, or are on public assistance programs like Medicaid or Medicare.

Many drugmakers have programs that help patients get started and stay on medicines for little or no cost. But those programs have not been reliable for medicines like Ozempic and Trulicity because of the supply shortages. And many insurers’ requirements that patients receive prior authorization or first try less expensive drugs add to delays in care.

By the time many of Rahman’s patients see her, their diabetes has gone unmanaged for years and they’re suffering from severe complications like foot wounds or blindness. “And that’s the end of the road,” Rahman said. “I have to pick something else that’s more affordable and isn’t as good for them.”

GLP-1 agonists — the category of drugs that includes Ozempic, Trulicity, and Mounjaro — were first approved to treat diabetes. In the last three years, the Food and Drug Administration has approved rebranded versions of Mounjaro and Ozempic for weight loss, leading demand to skyrocket. And demand is only growing as more of the drugs’ benefits become apparent.

In March, the FDA approved the weight-loss drug Wegovy, a version of Ozempic, to treat heart problems, which will likely increase demand, and spending. Up to 30 million Americans, or 9% of the U.S. population, are expected to be on a GLP-1 agonist by 2030, the financial services company J.P. Morgan estimated.

As more patients try to get prescriptions for GLP-1 agonists, drugmakers struggle to make enough doses.

Eli Lilly is urging people to avoid using its drug Mounjaro for cosmetic weight loss to ensure enough supplies for people with medical conditions. But the drugs’ popularity continues to grow despite side effects such as nausea and constipation, driven by their effectiveness and celebrity endorsements. In March, Oprah Winfrey released an hourlong special on the medicines’ ability to help with weight loss.

It can seem like everyone in the world is taking this class of medication, said Jody Dushay, an assistant professor of medicine at Harvard Medical School and an endocrinologist at Beth Israel Deaconess Medical Center. “But it’s kind of not as many people as you think,” she said. “There just isn’t any.”

Even when the drugs are in stock, insurers are clamping down, leaving patients and health care providers to navigate a thicket of ever-changing coverage rules. State Medicaid plans vary in their coverage of the drugs for weight loss. (Kentucky's does not.) Medicare won’t cover the drugs if they are prescribed for obesity. And commercial insurers are tightening access due to the drugs’ cost.

Health-care providers cobble together care plans based on what’s available and what patients can afford. For example, Cooper Harris’s insurer covers Trulicity but not Ozempic, which she said she prefers because it has fewer side effects. When her pharmacy was out of Trulicity, she had to rely more on insulin instead of switching to Ozempic, Rahman said.

One day in March, Brandi Addison, an endocrinologist in Corpus Christi, Texas, had to adjust the prescriptions for all 18 of the patients she saw because of issues with drug availability and cost, she said. One patient, insured through a teacher-retirement health plan with a high deductible, couldn’t afford to be on a GLP-1 agonist, Addison said.

“Until she reaches that deductible, that’s just not a medication she can use,” Addison said. Instead, she put her patient on insulin, whose price is capped at a fraction of the cost of Ozempic, but which doesn’t have the same benefits. “Those patients who have a fixed income are going to be our more vulnerable patients.”

Chair of U.S. Senate health committee demands maker of weight-loss drugs, most popular in Kentucky, cut their prices by two-thirds

Axios Visuals map, adapted by Kentucky Health News; click it to enlarge.

Sen. Bernie Sanders of Vermont, who chairs the U.S. Senate's Health, Education, Labor and Pensions Committee says the maker of two popular diabetes and weight-loss drugs Ozempic and Wegovy should lower their list prices of “to no more than what they charge for this drug in Canada,” The Washington Post reports.

Sanders, an independent who votes with Democrats, "is demanding that Novo Nordisk slash the prices of its blockbuster drugs Ozempic and Wegovy, citing a new study on the manufacturing costs of the diabetes and weight-loss medications," the Post reports.

Kentucky leads the nation in the percentage (about 2.1%) of residemts who have received a prescription for one of the new drugs created to fight obesity and diabetes, which can also aid weight loss.

"Researchers found that a month’s supply of semaglutide — the active ingredient in both drugs — could be manufactured for an estimated 89 cents to $4.73," the Post reports, but "Novo Nordisk charges $935.77 for four weekly injections of Ozempic in the United States, while it costs about $300 per month out-of-pocket in Canada."

In response, a Novo Nordisk spokesperson didn’t address manufacturing costs but said the Danish company offers several ways to help patients and "supports changes in policy to improve patient affordability and access for those living with chronic diseases," the Post reports.

UK diabetes research featured in group's annual research report

Brittany Smalls, Ph.D., is at upper right.

By Hilary Smith
University of Kentucky

One of the cover stories in the annual reserach report from the American Diabetes Association is about a University of Kentucky researcher devoted to helping rural Kentuckians — specifically in Appalachia — better manage their diabetes.

highlighting investments in advancing diabetes research and clinical practice. ADA research grants focus on innovative projects with high impact and help researchers establish collaborative networks to move their innovations into the hands of people living with diabetes.

Brittany Smalls an associate professor and the Dr. Claire Louise Caudill Professor in Family Medicine in the UK’s Department of Family and Community Medicine. Her futire work in Appalachia will look at intergenerational households, where large extended families often live together in the same home or throughout shared pieces of land. These families share everything from living spaces, meals, household chores, caregiving and more.

Such househodls are common in Appalachia, and so is a disproportionately high risk for Type 2 diabetes. The prevalence of Type 2 diabetes reaches 23% in Kentucky’s most rural counties, more than twice the state average.

Throughout her career of helping older adults with type 2 diabetes, Smalls quickly noticed that the adult children and grandchildren of those she worked with could also benefit from her research.

Thanks to an award from the ADA, Smalls will expand her focus from older adults with type 2 diabetes to entire families living with or who are at risk for the disease.

“By tapping into tight-knit family units, we can start to shift how people think about their health and how they think about each other,” Smalls said.

The cover story from the ADA’s report details Smalls’ work resulting from the award:

“She is piloting a health intervention that leverages social support within family units to promote nutrition and physical activity, which are key to mitigating obesity and type 2 diabetes. Each participating family will receive a tailored six-month lifestyle plan. 

“Only one adult needs a type 2 diabetes diagnosis for a household to be eligible, and a dietitian will engage them in medical nutrition therapy based on available foods. Participating families will receive ADA-backed recommendations for physical activity based on family members’ physical ability.”

Kentucky leads the nation in use of new class of drugs that fight diabetes and obesity; more than 2% of Kentuckians use them

Kentucky Health News

This story has been updated, as underlined.

Kentucky has the nation's highest rate of dispensed prescriptions for a new class of diabetes and obesity medications, according to the analytics company PurpleLab and published by Axios.

"For every 1,000 people in Kentucky, roughly 21 were prescribed a drug that belongs to a buzzy class of diabetes and anti-obesity medications last year," Tina Reed of Axios reports.

The drugs are GLP-1 agonists, which mimic a hormone that triggers the release of insulin, which lowers blood sugar; slows digestion; and increases the feeling of fullness after eating. They were developed to treat diabetes but have become popular in treating obesity, in which Kentucky ranks high.

"GLP-1 agonists alone can’t treat Type 2 diabetes or obesity," the Cleveland Clinic cautions. "Both conditions require other treatment strategies, like lifestyle and dietary changes." The drugs are costly, running between $900 and $1,300 a month, and most must be injected into fatty tissue.

Axios reports that after Kentucky, West Virginia had the next highest prescribing rate, at 18.9 prescriptions dispensed per 1,000 residents. That was followed by Alaska (17.5), Mississippi (16.1) and Louisiana (15.4). Rhode Island had the lowest rate (3.7), and Massachusetts was second lowest (4), followed by Wisconsin (4.3) and Hawai'i (4.3.)

The figures come from a collection of 1.9 billion claims to private insurers, Medicare (which only covers GLP-1s to treat diabetes) and Medicaid. "The data lumps the prescriptions together, so it's not possible to tease out how often these drugs are being prescribed for obesity versus diabetes," Axios notes. Kentucky Medicaid does not cover the drugs, but health insurance for state workers does.

In another story Reed reports, "Doctors are getting inundated with patients' requests . . . including from many who don't really need them. Primary-care doctors in particular, who typically have little training in obesity, have found themselves as gatekeepers for a class of injection drugs, including Novo Nordisk's Ozempic and Wegovy, that are effective but still face questions about who should take them."

East Kentucky Diabetes symposium to be held in Hazard Nov. 3

The inaugural East Kentucky Diabetes Symposium will be held Friday, Nov. 3 in Hazard.

In Kentucky's Appalachian counties, 16% of adults have diabetes, and the five area development districts with the highest mortality rates are in Eastern Kentucky, according to the 2023 Diabetes Report by the state Cabinet for Health and Family Services and the Personnel Cabinet.

The statewide rate was nearly 14%, reflecting the more than 486,000 Kentuckians who had diabetes in 2021. This rate has more than doubled since 2000, and another 12% of Kentuckians are at risk for developing diabetes.

Scheduled speakers at the symposium include:
· Dr. Steven J. Stack, commissioner, state Department for Public Health 
· Barry Martin, CEO, Primary Care Centers of Eastern Kentucky
· Dr. Kristen R. Stakelin, associate chief medical officer for specialty ambulatory services, Barnstable Brown Diabetes Center at UK HealthCare

· Chlodys Johnstone, Barnstable Brown Diabetes Center 
· Kim Bayes, diabetes prevention coordinator at UK King's Daughters Hospital, Ashland

The symposium will be held from 8 a.m. to 4 p.m. Nov. 3 at Primary Care Centers of Eastern Kentucky, 101 Town and Country Lane, Hazard. It is sponsored by Shaping Our Appalachian Region. The $25 registration fee covers all programming and a diabetic-friendly breakfast, lunch, and snacks. Register here.

Traveling with diabetes? Here are 10 tips for a safe, pleasant trip

By Tami Ross
University of Kentucky

Diabetes requires regular self-management and treatment, even on vacation. That’s why it is important to plan ahead to ensure that your next great adventure does not suspend your diabetes management.

Photo by Julia Amarai, iStock/ Getty Images Plus

Check in with your diabetes care provider: When in doubt, schedule an appointment with your diabetes care provider to discuss how your diabetes management may change while you are traveling. Your provider can let you know if your travels require any immunizations.

Ask your doctor for a letter detailing your diagnosis, how your diabetes is treated and what medication and equipment is required.

Notify the TSA agents about your medical devices: When flying, it is important to let TSA agents know beforehand that you have medical devices in your bag or on your person. This will help prevent any unnecessary hiccups, keep any diabetes devices safe, and speed you through security. It may be beneficial to bring a letter from your doctor stating your diagnosis and what supplies you are traveling with.

Take a TSA medical condition notification card: You may want to bring a TSA notification card to discreetly notify the agents of your diabetes. These cards should be printed and filled out ahead of time. This may be helpful if you have a child who is self-conscious about their diagnosis and does not want the extra attention that comes with notifying the agents.

Request a pat-down screening process: You can request a pat-down screening as an alternative to the airport full-body scanner. Some diabetes devices may be damaged by X-ray baggage machines or full-body scanners, so make sure to follow the device manufacturer’s recommendations.

Know that the 3.4 oz. rule doesn’t apply: Insulin and other liquid medications like glucagon are permitted through airport security even if they are greater than 3.4 ounces. You may travel with a juice box over 3.4 ounces to treat any potential low blood glucose, but it will receive additional screening. Lancets and syringes are also allowed through security but should be accompanied by insulin.

Keep medicines with you: Do not store insulin or other diabetes injectables in checked luggage or the trunk of the car. It could be affected by pressure and temperature changes. Keep any medication or blood testing supplies that you might need with you.

Make sure to have a pharmaceutical label for all your medication to show that it was prescribed by a physician when going through airport security. Try to pack twice as much medicine and diabetes supplies as you think you’ll need to be prepared for any travel delays or unforeseen circumstances.

Take frequent breaks: Since people with diabetes are at a higher risk of developing blood clots, which can lead to heart attack or stroke, try to take frequent breaks to stand up and walk around to help keep blood flowing.

Protect supplies from the sun: Make sure to keep your diabetes supplies out of the sun, and do not leave them in a hot or cold car. If you take insulin, keep it in a cooler, but avoid placing insulin directly on ice as it may get too cold or freeze, damaging it.

Bring healthy snacks: Travel with portable, ready-to-eat snacks in case of meal delays or food unavailability.

Dress comfortably: Wear comfortable clothing and supportive well-fitting shoes with plenty of cushioning. Make sure to never walk bare foot, even on the beach. While traveling, check your feet for swelling and blisters regularly.

Tami Ross is a nationally recognized registered dietitian and certified diabetes care and education specialist and a diabetes education services coordinator with UK's Barnstable Brown Diabetes Center.

UK study finds intimate-partner violence raises risk of developing diabetes, due to stress; Ky. has high rate of domestic violence

A diabetic checks blood sugar. (Photo by AaronAmat, iStock/Getty Images Plus)

By Sarah Ladd

Kentucky Lantern

People who experience intimate-partner violence, or the threat of it. are much more likely to end up with diabetes, due to increased stress. So says a new study published by a University of Kentucky researcher and others.

Experiencing violence, abuse and neglect as adults and children increased the risk of adult-onset diabetes in women and men by 23% to 35%, said the study, published in the American Journal of Preventive Medicine.

Researchers attributed the heightened risk to the elevated cortisol levels and suppressed insulin levels that occur in the human body in response to violence or chronic stress.

Ann Coker
(Photo provided)

UK researcher Ann Coker, who’s also a professor of epidemiology in the Department of Obstetrics and Gynecology in the university’s College of Medicine, said the study is the first of its kind.

“Before this research, we knew that partner violence was associated with diabetes among women, but we did not know that violence preceded diabetes development,” Coker said. “We had no data on this relationship for men or within racial groups.”

 
A recent statewide report on domestic violence showed nearly half of women and more than a third of men in Kentucky experience intimate partner violence or the threat of it.

In 2020, the Centers for Disease Control and Prevention showed 11.4% of Kentuckians had diabetes, a decrease from the two years prior.

Diabetes is a chronic condition that hinders the body’s ability to make enough insulin to properly break down foods, per the CDC. There are several different types of diabetes.

More than 37 million Americans have diabetes, the CDC says, and many don’t know it.

Additionally, Kentuckians experience high rates of child abuse and adverse childhood experiences.

Researchers collected data for the study before the Covid-19 pandemic. The pandemic may have made the risk of diabetes worse by increasing stress, another researcher in the study said.

“Our findings also show an increased risk in a timeframe before the additional social stress of the Covid pandemic,” said Dr. Maureen Sanderson, the study’s lead author and a professor in the Department of Family and Community Medicine at Meharry Medical College in Nashville, said in a statement.

“This strongly suggests the need for helping professionals across disciplines to implement effective violence prevention and intervention strategies to reduce the short and long-term social and health consequences of partner violence and child abuse,” Sanderson added.

Interventions, Sanderson said, can include “strengthening economic supports for families, promoting social norms to protect against adversity and violence, ensuring strong starts for children, teaching skills, connecting youth to caring adults and intervening to lessen harm.”

Ads and social media hype new, expensive weight-loss drugs; doctors sound alarms about off-label uses and side effects

AFP photo via Getty Images and KFF Health News

By Darius Tahir
and Hannah Norman

KFF Health News

Suzette Zuena is her own best advertisement for weight loss.

Zuena, the “founder/visionary” of LH Spa & Rejuvenation in Livingston and Madison, N.J, has dropped 30 pounds. Her husband has lost 42 pounds.

“We go out a lot,” Zuena said of the pair’s social routine. “People saw us basically shrinking.” They would ask how the couple did it. Her response: Point people to her spa and a relatively new type of medication — GLP-1 agonists, a class of drug that’s become a weight-loss phenomenon.

But she’s not just spreading her message in person. She’s also doing it on Instagram. And she’s not alone. A chorus of voices is singing these drugs’ praises. Last summer, investment bank Morgan Stanley found mentions of one of these drugs on TikTok had tripled. People are streaming into doctors’ office to inquire about what they’ve heard are miracle drugs.

What these patients have heard, doctors said, is nonstop hype, even misinformation, from social media influencers. “I’ll catch people asking for the skinny pen, the weight-loss shot, or Ozempic,” said Priya Jaisinghani, an endocrinologist and clinical assistant professor at New York University’s Grossman School of Medicine.

Competition to claim a market that could be worth $100 billion a year for drugmakers alone has triggered a wave of advertising that has provoked the concern of regulators and doctors worldwide. But their tools for curbing the ads that go too far are limited — especially when it comes to social media. Regulatory systems are most interested in pharma’s claims, not necessarily those of doctors or their enthused patients.

Few drugs of this type are approved by the Food and Drug Administration for weight loss; those include Novo Nordisk’s Wegovy. But after shortages made that treatment harder to get, patients turned to other pharmaceuticals, like Novo Nordisk’s Ozempic and Eli Lilly’s Mounjaro, that are approved only for Type 2 diabetes. Those are often used off-label — though you wouldn’t hear that from many of their online boosters.

The drugs have shown promising clinical results, Jaisinghani and her peers emphasize. Patients can lose as much as 15% of their body weight. Novo Nordisk is sponsoring research to examine whether Wegovy causes reductions in the rate of heart attacks for patients with obesity.

The medications, though, come at a high price. Wegovy runs patients paying cash at least $1,305 a month in the Washington, D.C., area, according to a GoodRx search in late March. Insurers only sometimes cover the cost. And patients typically regain much of their lost weight after they stop taking it.

Hype drives demand

But patients are not necessarily coming to doctors’ offices now because of the science. They are citing things they saw on TikTok, like Chelsea Handler and other celebrities talking about their injections. It leads to the questions “how come she can get it” and “why can I not,” said Juliana Simonetti, a physician and co-director of the comprehensive weight management program at the University of Utah.

The excitement — which doctors worry may cause some patients to use medications inappropriately — is coming also from business interests. Some are doctors promoting their venture-capital-backed startups. Others are spas hawking everything from wrinkle-smoothing and lip-plumping to, yes, weight-loss benefits of semaglutide, the active ingredient in Wegovy and Ozempic; their prices, often in the hundreds of dollars, are well below what consumers would pay if picking up the prescription at a pharmacy.

In the U.S., the FDA has oversight over ads from the pharmaceutical industry, which must acknowledge risks and side effects of drugs. But ads from people who write prescriptions don’t necessarily have the same restrictions. FDA regulations apply if the prescriber is working on behalf of a regulated entity, like a pharmaceutical manufacturer or distributor.

“The FDA is also committed to working with external partners, including the Federal Trade Commission, to address concerns with prescription drug marketing practices of telehealth companies on various platforms, including social media,” agency spokesperson Jeremy Kahn emailed KFF Health News.

Pharma firms run campaigns to educate health-care professionals or raise “awareness” that may indirectly tout drugs. Novo Nordisk has an ongoing internet campaign to redefine and destigmatize how Americans think of obesity — and, left unmentioned, the drugs that treat it.

Australian regulators have taken down nearly 1,900 ads as of early March for improperly plugging various GLP-1 agonists, an agency spokesperson told KFF Health News. Novo Nordisk says it didn’t put up the ads, the majority of which were for their product Ozempic. The regulators are declining to say who’s involved.

Doctors are also sounding alarms about the publicity. They believe patients will be driven to use these medications off-label, obtain unreliable forms of these drugs, or exacerbate other health conditions, like eating disorders. The drugs act in part as an appetite suppressant, which can dramatically reduce calorie intake to a concerning degree when not paired with nutritional guidance.

Elizabeth Wassenaar, a regional medical director of the Eating Recovery Center, said she believes the drugs and associated advertising buildup will inadvertently trigger eating disorders. KFF Health News found ads showing thin patients measuring themselves with a tape measure and stepping on the scale, with accompanying captions goading viewers into going on GLP-1s.

“They’re being marketed very, very pointedly to groups that are vulnerable to experiencing body image dissatisfaction,” she said.

Remi Bader, a curve model and TikTok creator specializing in documenting her “realistic” clothing buys, told one podcast her story of coming off a “few months” on Ozempic. She said she gained twice the weight back and that her binge eating disorder got “so much worse.” One study, published in the journal Diabetes, Obesity and Metabolism, found two-thirds of lost weight came back after discontinuation of semaglutide.

But social media users and influencers — whether with white coats or ordinary patients — are hopping on every platform to spread news of positive weight-loss outcomes. There are those, for instance, who had gastric bypass surgery that didn’t work and are now turning to TikTok for guidance, support, and hope as they begin taking a GLP-1. There’s even a poop-centric Facebook group in which people discuss the sometimes fraught topic of the drugs’ effect on their bowel movements.

Commercialism, compounding spark excitement, concern

Some have been so delighted by their medication-assisted weight loss they have become brand ambassadors. Samantha Klecyngier has dropped at least 58 pounds since she started on Mounjaro. She heard of the drug and her telemedicine weight loss program, Sequence, on TikTok. She and many others who have experienced considerable weight loss since starting the medication regimen point to its positive impact and their improved quality of life. Now she officially promotes the company on the app.

Though Klecyngier, a mother of two from the Chicago area, is not diabetic, she uses Mounjaro. When she was growing up, her parents had Type 2 diabetes and other chronic diseases that led them both to have open-heart surgery. Her father lost his life to complications of diabetes. She wants to avoid that fate.

But Klecyngier’s story — combining a personal journey with a profit-making entity — is symbolic of another trend on social media: commercialism. There’s a spate of startups eyeing big money matching pharmaceuticals and related support with patients. (Sequence, the company Klecyngier pitches, just got acquired by WW, also known as WeightWatchers.)

Some doctors use social media to educate viewers about the drugs. Michael Albert, chief medical officer of telehealth practice Accomplish Health, says offering information to his more than 250,000 followers has helped point patients to the medical practice. It’s received thousands of patient inquiries, more than the clinic can take on.

Companies like Accomplish — startups with well-credentialed doctors — are the glossy side of this social media boom.

But there are others — like many spas and weight loss centers — that offer the drugs, sometimes without much medical support, often alongside Botox and dermal fillers. Obesity doctors worry such marketing is creating unrealistic expectations.

Some spas and telemedicine operators claim to have “compounded” semaglutide. But compounding — when pharmacies, rather than drug manufacturers, prepare a drug — is a risky proposition, doctors caution. “The risks are enormous,” Simonetti said, warning of potential contamination from poor compounding practices. “The risks of getting bacteria,” she warned, “the risks include death.”

Weight loss clinics also frequently tout unconventional additions to semaglutide, including vitamin B-12 and amino acids. Some patients incorrectly believe the former helps with nausea, Jaisinghani said; other clinics tout greater weight loss.

Novo Nordisk spokesperson Allison Schneider told KFF Health News in an email that the company shares doctors’ concerns about compounding and that it’s begun sending letters warning “certain health-care providers” about the related risks.

Some operations defend their use of often-cheaper compounded drugs. LH Spa & Rejuvenation, founded by Zuena, offers a compounded semaglutide formulation from QRx Weight Loss for $500 over four weeks. The spa learned about the regimen from a doctor. “I’m purchasing it,” Zuena said. “It comes next-day air in legitimate vials with lot numbers, expirations.” Patients’ injections and dosages are overseen by on-site medical staff.

Most operators in this burgeoning industry are keen to emphasize their products’ high quality or their company’s good works, as they seek money. Ro, a telehealth firm offering GLP-1s, said its marketing campaign in the New York City subway “aims to start an important, sometimes difficult, conversation focused on de-stigmatizing obesity as a condition.”

This widespread tactic is nothing short of maddening for pharma-industry critics. “They talk about trying to destigmatize obesity at the same time they’re talking about losing weight. They’re co-opting the concept,” said Judy Butler, a research fellow at PharmedOut, a Georgetown University Medical Center project focusing on evidence-based practices for drugs. “They’re trying to sell a weight loss drug.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Lilly says it will cut prices of 2 old insulin products 70% this year, and immediately cap the cost of another one at $25 per vial

Eli Lilly & Co. announced Wednesday that it will cut the prices of some of its older insulin products this year "and immediately expand a cap on costs insured patients pay to fill prescriptions," The Associated Press reports.

That will provide "critical relief to some people with diabetes who can face annual costs of more than $1,000 for insulin they need in order to live," AP's Tom Murphy writes. "Lilly’s changes also come as lawmakers and patient advocates pressure drugmakers to do something about soaring prices."

Lilly said it will cut by 70 percent the list prices for its most-prescribed insulin, Humalog, and for another one, Humulin, in the fourth quarter of the year, which starts in September. "The drugmaker didn’t detail what the new prices would be," Murphy notes. "List prices are what a drugmaker initially sets for a product and what people who have no insurance or plans with high deductibles are sometimes stuck paying."

Stacie Dusetzina, a health policy professor at Vanderbilt University who studies drug costs, told Murphy that the changes probably won’t affect Indianapolis-based Lilly much financially because the two insulins already have competition.

The authorized generic version of another Lilly insulin, Humalog, will be cut to $25 a vial starting in May. "The cost of a prescription for generic Humalog ranges between $44 and close to $100 on the website GoodRx," Murphy notes.

Lilly's Indianapolis headquarters (Photo by Darron Cummings, AP)

Lilly CEO David Ricks said in a press release that it will take some time for insurers and the pharmacy system to implement the price cuts, so the company will immediately cap monthly out-of-pocket costs at $35 for people who are not covered by Medicare’s prescription-drug program. It said the cap applies to people with commercial coverage and at most retail pharmacies.

Medicare started applying that cap in January, as part of recent legislation.

"Aside from Eli Lilly and the French drugmaker Sanofi, other insulin makers include the Danish pharmaceutical company Novo Nordisk," Murphy reports. "Lilly also is launching in April a biosimilar insulin to compete with Sanofi’s Lantus."

Insulin is an essential hormone that converts food into energy. "People who have diabetes don’t produce enough insulin," Murphy notes. "People with Type 1 diabetes must take insulin every day to survive. More than 8 million Americans use insulin, according to the American Diabetes Association. Research has shown that prices for insulin have more than tripled in the last two decades, and pressure is growing on drugmakers to slow the increases."

Drug manufacturer may be seeing “the writing on the wall that high prices can’t persist forever,” said Larry Levitt, an executive vice president with the nonprofit Kaiser Family Foundation, which studies health care, told Murphy. “Lilly is trying to get out ahead of the issue and look to the public like the good guy.”

Lilly was the first company to commercialize insulin in 1923, "two years after University of Toronto scientists discovered it," Murphy notes. "The drugmaker then built its reputation around producing insulin even as it branched into cancer treatments, antipsychotics and other drugs."

How to avoid vision problems from diabetes, which 13.6% of Kentuckians have, 7th in U.S.; 33.8% more have pre-diabetes

Diabetes can cause blindness. (smirart/iStock/Getty Images)

By Joseph Brown

University of Kentucky

Diabetes is a disease so prevalent in the U.S. that it is considered to be an epidemic. In Kentucky, according to the American Diabetes Association, approximately 13.6% of the adult population has diagnosed diabetes, seventh in the nation.

Another 33.8% of Kentuckians have been diagnosed as having pre-diabetes. Diabetes can result in devastating consequences financially and physically for the families and those who have it.

With a diabetes diagnosis, you must be aware of the risk factors you face. One of these risk factors is that you can develop a serious eye condition called diabetic retinopathy. It causes vision loss and blindness in those who have diabetes by causing issues with the blood vessels connected to the retina.

If you have diabetes, it is important to get an eye exam once a year, since you may not notice any symptoms in early stages. Catching this condition early on will be the best course of action in preventing vision loss.

What are the symptoms?

• Changes in vision such as trouble reading or blurred vision
• Fluctuating vision
• Spots or dark streaks floating in your vision
• Dark or empty areas in your vision
• Eye pain or redness
• Difficulty seeing in the dark

What can I do to prevent diabetic retinopathy? The best course of action is managing your diabetes with a healthy diet, regular exercise and following your doctor’s instructions with medications. You should also ensure you get a regular eye screening, and monitor your blood sugar, cholesterol and blood pressure at all times.

What kind of treatment is available? If caught early, your doctor will likely recommend more regular eye exams. However, in the later stages, there are a variety of treatments available to stop your vision from worsening, such as injections, laser treatment or eye surgery. Overall, it is important to see your doctor with any concerns you may have to find the right course of action for you.

Study: If you're obese or diabetic, and get over 20% of calories from fast food, you're more likely to get a deadly liver disease

Photo from WomenFitness.net

People who are obese or diabetic and get 20 percent or more of their calories from fast food are more likely to get non-alcoholic fatty liver disease, a potentially life-threatening condition, says a new study from the University of Southern California.

The study, published in the peer-reviewed journal Clinical Gastroenterology and Hepatology, "gives people extra motivation to reduce fast-food consumption," a USC news release said. The study found that beyond the obese and diabetic, "The general population has moderate increases of liver fat when one-fifth or more of their diet is fast food."

“Even a moderate increase in fat can lead to non-alcoholic fatty liver disease,” said  Dr. Ani Kardashian, a USC hepatologist and lead author of the study. “The severe rise in liver fat in those with obesity or diabetes is especially striking, and probably due to the fact that these conditions cause a greater susceptibility for fat to build up in the liver.”

Obesity and diabetes are big health issues in Kentucky. The state ranks first in obesity among childen aged 10 to 17, third in percenatge of the population considered obese, and seventh in percentage with diabetes.

Earlier research has shown links between fast food and obesity and diabetes, but this is one of the first studies to demonstrate the negative impact of fast food on the liver, Kardashian said.

“If people eat one meal a day at a fast-food restaurant, they may think they aren’t doing harm,” said Kardashian. “However, if that one meal equals at least one-fifth of their daily calories, they are putting their livers at risk.”

Nonalcoholic fatty liver disease, also known as liver steatosis, can lead to cirrhosis, or scarring of the liver, which can cause liver cancer or failure, USC says. Liver steatosis affects over 30% of the U.S. population.

The study was based on the nation’s largest annual nutrition poll, the National Health and Nutrition Examination Survey. It characterized fast food as meals, including pizza, from either a drive-through restaurant or one without wait staff. It looked at about 4,000 adults whose fatty-liver measurements were included in the survey and compared these measurements to their fast-food consumption.

"Of those surveyed, 52% consumed some fast food. Of these, 29% consumed one-fifth or more daily calories from fast food. Only this 29% of survey subjects experienced a rise in liver fat levels," USC says.

"The association between liver steatosis and a 20% diet of fast food held steady for both the general population and those with obesity or diabetes even after data was adjusted for multiple other factors such as age, sex, race, ethnicity, alcohol use and physical activity."

Kardashian said, “Our findings are particularly alarming, as fast-food consumption has gone up in the last 50 years, regardless of socioeconomic status. We’ve also seen a substantial surge in fast-food dining during the Covid-19 pandemic, which is probably related to the decline in full-service restaurant dining and rising rates of food insecurity. We worry that the number of those with fatty livers has gone up even more since the time of the survey.”

Kardashian said she hopes the study will encourage health-care providers to offer patients more education about nutrition, especially to those with obesity or diabetes ,who are at higher risk of developing a fatty liver from fast food. The only known way to treat liver steatosis is through an improved diet.

More than 1/3 of Kentuckians are enrolled in Medicaid. How many in your county? How many kids? What are their big health issues?

Screenshot of health portion of Cabinet for Health and Family Services report on Clay County

By Al Cross

Kentucky Health News

Most Kentuckians probably don't know much about Medicaid, but for more than one in three people in the state, it is a lifeline. In some counties, more than half the residents are Medicaid beneficiaries. But Medicaid runs somewhat under the radar, because many Kentuckians frown on the receipt of public assistance -- even though Medicaid benefits come only with demonstrated medical need.

Medicaid is a combined federal-and-state program, created in 1965 by the law that created Medicare. Originally it was for the very poor, the disabled and the pregnant, but in 2014 expanded to households with incomes up to 138 percent of the federal poverty level because then-Gov. Steve Beshear embraced the 2010 Patient Protection and Affordable Care Act, better known as Obamacare.

The federal government pays 90 percent of the cost for people covered by the expansion, and about 72 percent of others' costs. The state pays the rest, which means Kentucky taxpayers put billions of dollars a year into it. It's not the sort of program that needs to run under the radar; if we are paying the freight, we need to know what's in the haul, and it helps to know it at the local level.

That's easier now that the state Cabinet for Health and Family Services, which runs Medicaid in Kentucky, has posted monthly Medicaid enrollment reports on its website.

These county-by-county reports are more useful than the annual reports that the cabinet circulates more more to show the local impact of its programs. The Medicaid figure on those reports is the number of people in the county who received Medicaid benefits at any time during the program's fiscal year (April to March). That number overstates the rolls at any particular time, because many people go on and off Medicaid each month.

For example, the Fiscal 2022 report for Clay County, one of the nation's poorest, shows 15,922 total beneficiaries in the year, but only 12,815 in the month of June. That is still 62.6 percent of the county's estimated population of 20,484.

That said, the annual reports provide much more information about Medicaid than the monthly reports; among other things, they:

• Break down Medicaid enrollment into types of enrollees: traditional, expansion, children in foster care, and "presumptive eligibility," people who have been enrolled during the pandemic without all the usual checks for eligibility, under legislation passed by Congress. Starting April 1, states will have to start running all the usual checks, and many people will no longer be eligible. In Clay County, for example, 2,842 presumptive eligibles were on the rolls in fiscal 2022, or 18% of the total enrollment.
• Give the number of children who were beneficiaries at any time during the year; in Clay County, 4,612 kids were helped by Medicaid in fiscal 2022. 
• Give the top five diagnoses for adults and children on Medicaid, which can vary widely from year to year. In another poor county, Clinton, the top five diagnoses for adults in fiscal 2021 were chronic obstructive pulmonary disease, hypertension, unspecified illness, opioid dependence and diabetes, in that order. In fiscal 2022, they were hypertension, Covid-19, contact with and suspected exposure to Covid, myopia (nearsightedness) and "other fatigue."
• Give the top five procedures performed on beneficiaries and the top five medications prescribed for beneficiaries. In both Clay and Clinton counties in the last two fiscal years, the most-prescribed drug was naloxone, which reverses the effect of a drug overdose.
• Show the number of health-care providers who served residents of the county and the total they were paid. For example, in Clinton County in fiscal 2022, residents were served by 48 providers who were paid $33 million; $14.3 million of that went to local providers.
• Show the number of newborn screenings and other figures on programs for children, including the percentages of foster children who had an official goal of adoption, and the number with other official goals, such as reunification with their birth families.

The annual reports give much information on programs other than Medicaid, such as the Supplemental Nutrition Assistance Program (once known as food stamps), behavioral-health services (including syringe exchanges), other services by local health departments, health-insurance assistance, child-care assistance, child-support enforcement, social services (such as meals, home care and other services to seniors), and funding of Family Resource and Youth Service Centers, which serve public-school students and their families. The reports also list the number of cabinet employees working in each county.

$35 cap on seniors' monthly insulin costs isn't reflected in online 'plan finder' that is used by Medicare members to choose a plan

Screenshot of Medicare plan finder; for the web page, click here.

By Susan Jaffe
Kaiser Health News

A big cut in prescription drug prices for some Medicare beneficiaries kicks in next year, but finding those savings isn’t easy.

Congress approved in August a $35 cap on what seniors will pay for insulin as part of the Inflation Reduction Act, along with free vaccines and other Medicare improvements. But the change came too late to add to the Medicare plan finder, the online tool that helps beneficiaries sort through dozens of drug and medical plans for the best bargain.

Officials say the problem affects only 2023 plans.

To fix anticipated enrollment mistakes, Medicare officials will give beneficiaries who use insulin a chance to switch plans next year. They can make one change after Dec. 8 and throughout 2023 through a special enrollment period for “exceptional circumstances.” Typically, people are locked in for an entire year.

The Centers for Medicare & Medicaid Services provided initial details of the opportunity in a document distributed to the State Health Insurance Assistance Program, or SHIP, which assists Medicare enrollees in every state. Although Medicare did not publicize the document, beneficiaries can get more information by contacting their local SHIP office. CMS officials would not answer questions about whether the ability to change plans will be granted automatically.

State counselors and contractors such as regional Aging and Independent Living councils "are advising Medicare beneficiaries as they call in that while the cost is currently not reflective, they will see a decrease in their insulin costs effective January 2023," Kentucky health cabinet spokeswoman Susan Dunlap said. "A handout was created and shared with all SHIP counselors to educate the public on this."

In some cases, a special enrollment period can be avoided, said Janet Stellmon, SHIP director in Montana. If the plan charges more than a $35 copayment for a member’s insulin, a SHIP counselor can ask the plan to correct the mistake, said Stellmon, who helped one beneficiary save $565 a month on insulin: “Plans usually try to make it right quickly.”

Medicare patients spent $1 billion in 2020 on insulin products — four times the amount in 2007, with some paying as much as $116 a month out-of-pocket, KFF has found. Americans paid an average of five to 10 times as much for insulin in 2018 than in other countries, according to a recent study. About 3.3 million people with Medicare rely on one or more insulin products to control blood sugar levels.

The $35 copay for injectable insulin products takes effect Jan. 1, and July 1 for patients who use an insulin pump.

When beneficiaries who use insulin now check the plan finder, the price could show up as thousands of dollars a year instead of the maximum $420 stipulated by law. An inaccurate price could also distort the costs of other drugs, which depend on what coverage phase patients reach. For example, once both the plan and the patient spend a total of $4,660 for all drugs next year, the member pays no more than 25% of the cost for non-insulin drugs.

It’s extremely difficult for consumers to evaluate policy options without the plan finder. One plan might have the lowest price for one drug but not another. Or a plan might have the lowest premium but higher drug prices. Or a preferred pharmacy in one plan may be excluded in another.

The finder does display a warning: “This new $35 cap may not be reflected when you compare plans. You should talk to someone for help comparing plans.” It points readers to the Medicare help line — 800-633-4227 — or a counselor with SHIP.

It doesn’t mention the option of changing plans after the Dec. 7 enrollment deadline, but both SHIP counselors and representatives answering the Medicare help line rely on the same flawed plan finder.

Drug plans do not have to cover all injectable insulins, said Tatiana Fassieux, an education and training specialist at California Health Advocates. “It’s all about the formulary,” she added, referring to the list of drugs covered by a plan.

Time for pharmacy-benefit managers to 'share the savings' in prescription-drug costs, crusaders against diabetes write

OPINION By George Huntley and Stewart Perry

George Huntley of Indianapolis is CEO of the Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition. He has lived with Type 1 Diabetes for 39 years. Lexington insurance agent Stewart Perry is a lifelong patient advocate living with Type 2 diabetes and a founding member of the Diabetes Leadership Council.

American health-care innovation has saved countless lives. Whether it’s a new vaccine to prevent serious illness, or a breakthrough treatment to help someone manage a previously debilitating chronic disease, we owe a lot to those researchers and scientists in white lab coats.

But what if they toiled away in the lab to make that new medicine and no one could access or afford it? And what if the reason was because some unknown middleman was dictating the cost and skimming vast sums of money off the top to pad their bottom line?

While we’d like to think that no one would stand for such a thing, this is unfortunately what happens every day in our modern health-care system.

It should be a lot simpler. Scientists develop a medicine, physicians determine when to prescribe it, pharmacists dispense it, and a patient takes it to manage their health. But somehow it became commonplace for an insurance company to dictate which medicines a patient can take—and for a pharmacy benefit manager, or PBM, to determine how much they pay for it. And we’re supposed to believe they do this to help businesses and individuals save money.

Because of these unfair practices, tens of millions of Americans struggle at the pharmacy counter. And with worsening inflation on all the other necessities of life, this situation is only getting worse. In fact, the Kaiser Family Foundation found that 30 percent of patients don't take their prescriptions as prescribed due to cost—and instead, choose to cut pills, skip doses or not fill prescriptions at all.

If you’re still not convinced, consider this: in recent years, the net prices of drugs—the list price, minus rebates and other discounts and reductions—have been going down. This should translate to lower costs for patients, but we’re seeing the opposite. Patients are spending more on prescription medications, even though PBMs and insurers are hauling in more savings.

Not surprisingly, PBMs and insurers are working hard to protect the complex web they’ve created to snare as much money as possible and increase their profits. But legislators at the state and federal levels are continuing to fight on patients’ behalf—and thanks to their efforts, we’re moving in the right direction.

In 2020, the Kentucky General Assembly passed groundbreaking legislation to rein in PBMs’ involvement in the state’s Medicaid program by creating a single drug formulary, managed by one PBM. Cutting out multiple unnecessary PBMs is expected to save taxpayers hundreds of millions of dollars a year, while ensuring patients can more easily access the medications they need to manage their health.

Of course, additional work remains to ensure patients are not bearing the brunt of PBMs’ unfair practices. That’s why a large and growing group of patient advocates and health-care providers are encouraging legislators to focus on patients over PBM profits—and are calling for legislation that would require middlemen to share manufacturer rebates directly with patients at the point of sale.

PBMs and insurers negotiate with drug manufacturers to get lower prices on prescription medicines. In theory, these savings should be passed along to patients to reduce their out-of-pocket costs. In reality, the system allows PBMs and insurers—massive, billion-dollar corporations—to keep the rebates, while continuing to charge patients higher prices for their medications.

“Share the savings” legislation would put an end to this unfair practice—and could save Americans living with chronic diseases hundreds or even thousands of dollars per year. That’s more money in the pockets of Kentuckians where it belongs.

PBMs and insurers defending the status quo argue that premiums will rise sharply if these rebates are shared with patients. And they also falsely claim that it will increase the costs for our businesses as well. But actuarial studies show that's not true, including a 2022 study from Milliman that projects an increase in premiums of less than 1 percent—and that's not even counting the savings from reduced hospitalizations that would result from patients taking their medications as prescribed.

The truth is that patients can't afford not to share in these rebates. And that’s why it’s time for PBMs to start sharing the savings.

The share of Kentuckians with diabetes has increased 28% in Kentucky since 2011, the fifth highest increase in the nation

Centers for Disease Control and Prevention map, adapted by Ky. Health News; click on it to enlarge

By Melissa Patrick

Kentucky Health News

The number of people living with diabetes in Kentucky has increased 28 percent since 2011, the fifth largest increase among the states, according to an analysis of Centers for Disease Control and Prevention data.

The report by Quote Wizard is based on the CDC's Behavioral Risk Factor Surveillance System, which askes adults if they have ever been told by a doctor that they have diabetes. In 2011, 10.8% of Kentucky respondents answered yes; in 2021, that number increased to 13.8%, an increase of 28%.

Nationwide, the report says there has been a 15% increase in the number of Americans with diabetes, with nearly 40 million people, or one in 10, having it. Another 100 million, or one in three, are estimated to be pre-diabetic.

The numbers are likely much larger. According to the American Diabetes Association, 101,000 people in Kentucky have diabetes, but don't know it, and 1.2 million Kentuckians have prediabetes. "Every year an estimated 31,090 people in Kentucky are diagnosed with diabetes," says the association. 

Why does it matter? Diabetes is the nation's No. 7 cause of death and the No. 1 cause of kidney failure, lower-limb amputations and adult blindness, according to the CDC.

The report also looked at the cost of diabetes in each state, including the average cost of insulin per year and the average diabetic's healthcare costs in each state.

"From 2012 to 2017, the direct medical cost for diabetes went from $245 billion to $327 billion a year. On average, diabetics spend more than $6,700 a year on medical care — twice as much as non-diabetics," says the report. "The price of insulin is also a major factor in the cost of diabetes. Insulin prices are up 600% in the last 20 years."

The American Diabetes Association reports that diabetes costs among Kentuckians who have been diagnosed with the disease costs an estimated $5.2 billion a year. 

Quote Wizard estimates that Kentucky diabetics' average annual cost for insulin is $584 and their average health-care costs are $6,266. Nationwide, the average insulin cost is $572 a year.

Norton Children's Hospital gets $15 million for diabetes institute

Norton Children’s Hospital and the Lift a Life Novak Family Foundation today announced the creation of the Wendy Novak Diabetes Institute. 

The foundation has given the hospital $15 million as the starting point of a $60 million plan to expand diabetes care for children and adults, as well as build the top diabetes institute in the country, a news release said. The institute will enhance services already available through the current Wendy Novak Diabetes Center. 

Nearly half a million children and adults in Kentucky have Type 1 or Type 2 diabetes, a rate of 14%, making Kentucky the eighth worst in the nation, according to the Centers for Disease Control and Prevention. 

The goal of the Wendy Novak Diabetes Institute is to become a national center of excellence by expanding and elevating diabetes care across the region, while helping children and adults with diabetes manage their conditions, and making it easier for patients to transition from pediatric to adult care. 

 “We are confident that with the strategic partnership with Norton Children’s and Norton Healthcare, and the outstanding leadership of Dr. Kupper Wintergerst, one of the most renowned endocrinologists in the world, we can continue to climb the rankings and become the best practice institution others will want to emulate,” David Novak, founder of the foundation, said in the release. “We see this impacting not only Louisville, but the world.” 

One of the first initiatives of the institute will be to provide more patient support through expansion of the diabetes education program. "Living with diabetes is an enormous burden, and educators are able to help each child and adult face every one of life’s challenges.” Wintergerst said in the release. 

Wendy and David Novak with daughter Ashley
(Photo by Pat McDonogh, The Courier Journal)

Wintergerst is a pediatric endocrinologist with Norton Children’s Endocrinology, which is affiliated with the University of Louisville School of Medicine, where he is the Wendy L. Novak Chair of Pediatric Diabetes Care and Clinical Research.

Norton Healthcare says it provides care for more than 69,000 patients with diabetes, spanning 137 counties in Kentucky and Southern Indiana. About 1,400 of the patients are children, says the release.

Looking forward, the Norton Children’s Hospital Foundation and Norton Healthcare Foundation have committed to raising another $12 million for a total $27 million investment. So far, $2 million has been raised. In the coming years, the goal is to raise additional funds to reach the $60 million vision.

The Lift a Life Novak Family Foundation was established in 1999 through a charitable trust by David and Wendy Novak. It funds innovative, high-impact projects that are led by passionate leaders committed to outstanding execution. Wendy Novak has had Type 1 diabetes since she was 7 years old, reports Maggie Menderski of the Louisville Courier Journal.