In a first-of-its-kind study, researchers used a unique dataset to show that patients with type 2 diabetes have significantly worse financial outcomes than other patients.
Findings showed diabetes patients fared worse on all seven financial outcomes studied, including below-prime credit scores, medical and non-medical debt in collections, 60-plus-day delinquent debt, debt charge-offs, bankruptcy filings and foreclosure.
The diabetes patients in this study were compared to people who had a blood test to check for diabetes but who were not diagnosed with diabetes, said Cäzilia Loibl, co-author of the study and professor and chair of consumer sciences at The Ohio State University.
"We found that patients with diabetes are more burdened financially than other patients," Loibl said.
The study was published today (July 28, 2025) in the journal JAMA Network Open.
Researchers used data on 166,285 patients being treated at the Wexner Medical Center at Ohio State from October 2017 through December 2021. They analyzed electronic health records linked to credit records and employment information on all the patients. Information that could identify the patients was stripped from the records.
While other research has suggested that diabetes patients often face financial difficulties, the dataset in this study sets it apart, said study co-author Stephanie Moulton, professor in Ohio State's John Glenn College of Public Affairs.
"We were able to link credit data, employment data and medical data, providing a unique look at the connection between physical and financial health in diabetes patients," Moulton said.
"That's one of the biggest strengths of this study."
Findings showed that patients with diabetes had more adverse financial events on average (1.9) than patients without diabetes (1.2).
Nearly two-thirds of diabetes patients were estimated to have an adverse financial outcome (64.5%), compared to half of other patients (49.9%). Diabetes patients were also much more likely to have below-prime credit scores (59.7% versus 45.9%). Other financial outcomes had similar results.
"Every financial outcome you could look at, diabetes patients fared worse," Loibl said.
Findings also showed a higher risk for adverse financial outcomes for diabetes patients who were Black or Hispanic, enrolled in Medicaid, younger than 65 years, female and without earned income.
The findings didn't surprise co-author Joshua Joseph, an associate professor of endocrinology, diabetes and metabolism at Ohio State who treats diabetes patients at the Wexner Medical Center.
"Finances are a major challenge for many of the patients I treat, so much so that we are asking them questions around what we call the social determinants of health in our patient visits," he said.
Economic stability is one of the social determinants of health that researchers have found affect a wide range of health outcomes. Diabetes is no exception.
For example, studies have shown that 20-25% of adults with diabetes have rationed insulin, while approximately 30% have rationed diabetes supplies. In addition, diabetes patients often don't follow care recommendations and have lower health care use, partly because of financial concerns.
"Our data point to substantial financial hardships for patients with type 2 diabetes and help explain why so many ration medicine and don't follow the health care recommendations that could help them control their disease," Joseph said.
Why is economic hardship more common for diabetes patients compared to those with other diseases?
The study did not examine why diabetes patients had worse financial outcomes, but the authors hypothesized several reasons. One is that it is a chronic disease that requires specialized care and costly medication, usually for life. The disease can also impact employment opportunities and career development.
"Our results really speak to the importance of screening diabetes patients for finances and debt issues," Joseph said.
"But beyond screening, we also need to ensure they have access to resources in the community that can help them to ultimately improve their financial situations. It is critical for their health and well-being," he said.
Other co-authors, all from Ohio State, were Matthew Pesavento, Donald Haurin, Madison Hyer and Djhenne Dalmacy.
