Ask an Expert: What Are Barriers to Type 2 Diabetes Treatment?

This article is part of Health Divide: Type 2 Diabetes in People of Color, a destination in our Health Divide series.

Do-Eun Lee, MD

Zoe Hansen / Verywell

Meet the Expert

Do-Eun Lee, MD, has been practicing medicine for more than 20 years and specializes in diabetes, thyroid issues, and general endocrinology. She currently operates a private practice in Lafayette, CA, which opened in 2009. She has authored several publications and is the recipient of various professional awards and honors, including the Young Investigator Travel Award from Seoul National University College of Medicine Alumni Association of North America, Las Vegas.

People with type 2 diabetes may face barriers to treatment, which can prevent them from receiving the care they need to manage their condition.

Some of these include financial barriers—like effective but pricy medications that insurance companies don’t always want to pay for—or societal barriers—like where a person lives and the types of medical care close to them.

Below, Do-Eun Lee, MD, an endocrinologist specializing in diabetes treatment, discusses how barriers to type 2 diabetes impact different groups of people and why it’s important to reduce barriers so people can receive necessary treatment.

Verywell Health: What financial barriers exist to type 2 diabetes treatment?

Dr. Lee: Financial barriers can prevent people from getting the best diabetes treatment. New medications that are very helpful for people with diabetes tend to be expensive—and people who are not financially well off tend to be on cheaper medication, even though it is less effective.

Verywell Health: Does the quality of treatment vary at different practices?

Dr. Lee: Yes. Receiving treatment from an endocrine practice versus a primary care practice looks very different. At an endocrine practice like mine, we tend to utilize newer medications—which can be highly effective but expensive.

For example, about 99% of type 2 diabetes patients at an endocrine practice are given a GLP-1 receptor medication—a disease-modifying medication. If they go to primary care physicians, about 5% to 10% of people will get the same medication. So it’s a stark difference.

The reason for this is likely the cost. Typical retail prices for GLP-1 receptor medications are about $1,000 a month. Insurance companies don’t want to pay for it, so they make it difficult for primary care physicians to utilize it.

Verywell Health: Money aside, what other barriers may prevent people with type 2 diabetes from getting the best treatment they need?

Dr. Lee: Not all people speak American English, so language barriers can complicate care. People with language barriers tend not to complain to healthcare providers. So, even though there is an opportunity to use a better medication, they may not ask for it, and it may not be utilized.

Verywell Health: How can financial barriers to type 2 diabetes treatment be reduced?

Dr. Lee: Well, manufacturers can make their medications priced lower. And insurance companies can start broadening their coverage when healthcare providers say a person needs it.

I wish insurance companies approved these medications off the bat instead of fighting with them myself. As healthcare providers, we’re busy; we don’t have a lot of time to fight with insurance companies. 

So, it would be huge if pharmaceutical companies and insurance companies worked together to lower the costs.

Verywell Health: What other types of access barriers should be struck down?

Dr. Lee: We should make telemedicine an available source of visits so that people don’t have to miss visits for work or other types of appointments. We should also help people gain access to healthy lifestyles, like access to swimming pools and good grocery stores.