Diabetes hasn’t stopped Michael Williams from living a full and active life, but the disease has been complicated – and costly – to manage.

There are blood-monitoring tests. The insulin pump. The medications to ward off potential complications such as heart problems. Regular visits to the doctor. Even with insurance, Williams ends up spending as much as $300 a month out of pocket to stay healthy.

“It adds up really quickly,” said Williams, 34, a computer technician at Lawrence Memorial Hospital. He added, “You pay now or you pay later, and it’s more expensive later.”

It’s a growing expense, either way. Just less than 4 percent of Kansans had diabetes in 1992; that number had grown to 6.5 percent in 2004 and is still rising. At Lawrence Memorial Hospital, officials say they see 500 new diagnoses of diabetes each year.

“In the beginning, I didn’t even do this full-time,” said Pat Hohman, who has been with the Diabetes Education Center at LMH since 1992. “Now I do this full-time.”

Michael Williams, of Lawrence, gets a demonstration on a new infusion set for a pump he uses for his diabetes, as Pat Hohman, Law-rence Memorial Hospital's diabetes educator, talks about the system.

She added, “We know right now we’re seeing epidemic levels of diabetes.”

Even as the disease grows, the city is losing its only full-time endocrinologist, who specializes in glandular conditions, including diabetes. Dr. Richard Fairchild is taking his practice to Topeka. Another endocrinologist, Dr. Chryse Sindler, visits Lawrence from Topeka twice a month.

Medical officials say Lawrence’s diabetes patients still will be able to get help with their disease from family practice doctors and aren’t far from endocrinologists in Kansas City and Topeka if they need specialized care.

Williams, though, is concerned.

“It will have an impact,” Williams said. “I don’t think that primary care physicians can keep up with diabetes the way a specialist can.”

Growing costs

Diabetes is a disease in which the body cannot produce or use insulin to convert sugar and other food into energy. As much as 95 percent of all cases are Type II diabetes, which has a variety of possible causes: old age, family history and race.

• 6News video: More Americans diagnosed with diabetes daily
• Diabetes.org: Statistics

It’s another possible cause – growing obesity rates – that is being blamed for the rise in diabetes cases in Kansas and nationwide.

“We’re on the same (rising) overweight curve that everybody else is,” said Dr. Joseph Kyner, an endocrinologist and assistant dean at the University of Kansas Medical Center in Kansas City, Kan.

While diabetes rates in Kansas lag behind the national average of 7 percent, the growth of the disease here has alarmed state leaders. The Kansas Department of Health and Environment estimates that the price of diabetes in the state – both from direct medical expenses and indirect costs such as lost productivity – amount to $1.3 billion a year.

Paula Marmet, director of the Office of Health Promotion at KDHE, said more than half of those costs are borne by state and federal governments.

Rising diabetes rates will increase that tab, she said.

“We did a forward projection on costs,” Marmet said. “Based on 2002 national estimates, we projected that the cost would rise to $1.8 billion in the next 15 years. And I have to say that’s a conservative estimate.”

Resources needed

Over time, diabetes can lead to heart disease, blindness, skin sores, foot problems and other complications. Kyner said Kansas doctors can expect to see growth in such problems in coming years.

“Those don’t come on overnight, in a week or even a year. It usually takes five to 10 years to develop,” Kyner said. “This so-called epidemic has just been in the last five to 10 years, so I don’t think we’ve seen all the complications we will see.”

Williams staves off such problems through a variety of medications and monitoring, including quarterly visits to Fairchild, his endocrinologist. Hohman, of the LMH Diabetes Education Center, said Williams’ schedule of visits to the specialist is typical.

But Fairchild’s departure, she said, shouldn’t be cause for alarm.

“For the most part, the primary care physician can take care” of diabetes patients, Hohman said.

Patrick Ayers, executive director of the American Diabetes Assn. chapter in Overland Park, disagreed.

“It’s obviously a concern to anybody with diabetes,” Ayers said Wednesday. “Primary care physicians or family doctors are nice people, but they’re not the best people to treat diabetes. Endocrinologists are the specialists.”

It’s not just Lawrence’s problem. There are just 40 endocrinologists to treat 326,000 diabetics in the 50-county area of Kansas and Missouri served by his organization, Ayers said.

“We need to attract people to the field of endocrinology,” he said. “I think in the past, diabetes hasn’t been a very sexy field to get into.”

That could change, though, as the rate of diabetes continues to rise.

“It’s a concern because it’s a chronic disease that affects a broad cross-spectrum of the population,” Kyner said. “It’s not just a disease that covers the wealthy or the poor. It covers everybody.”