In Australia, trauma insurance, also known as critical illness insurance, is available to those who suffer from diabetes.
Diabetes is a medical condition which occurs when the body produces insufficient amounts of insulin, resulting in the failure to automatically regulate blood glucose levels. This results in an overload of glucose (sugar) in the blood.
As the body’s preferred source of energy, glucose is produced when we consume foods that contain carbohydrates (starches and sugars); egg, milk and dairy products, bread, cereals, fruit and some vegetables. It is transported via the blood stream to muscles and organs, where it is used as fuel. Any excess glucose is sent to the liver, where it is stored in reserve.
The role of insulin
Blood glucose levels are regulated with the help of insulin, a hormone created by the pancreas. Insulin is the ‘key’ that glucose needs to enter the body’s cells so that it can be used as fuel.
Diabetes occurs when
– the pancreas stops producing insulin (‘Type 1 diabetes’ and 15% of diabetics) or
– when the body does not respond as it should to insulin (‘Type 2 diabetes’ and 85% of diabetics).
Insulin injections are necessary to treat Type 1 diabetes.
Type 2 diabetes can usually be controlled (in the first instance) by regular exercise and a healthy diet. However, tablets (and eventually insulin injections) may be required if the disease progresses.
Normal adult non-fasting blood glucose levels range between 3.5-7.8 mmol/l (‘millimoles/litre’), while fasting levels should be between 3.5-6.1 mmol/l. Blood glucose in excess of these levels can, over time, cause damage to blood vessels and nerves.
Resulting complications can impair the eyes and kidneys, and also significantly increase the risk of heart attack, stroke, and circulatory problems. This damage can sometimes happen before an individual even becomes aware they have diabetes.
How prevalent is diabetes?
Diabetes in Australia is now a common condition. One in twelve Australian adults are diabetic, and this number is increasing. Health authorities note that for every recorded case of diabetes, another exists undiagnosed (1).
Diabetes risk factors
The development of diabetes is very much influenced by our lifestyle and genes.
Diabetes may be prevented (or at least delayed) by maintaining a healthy lifestyle (including a Body Mass Index within the ‘normal’ range), balanced diet, and in particular, regular exercise.
International evidence has shown that significant changes to the lifestyle of high-risk patients can reduce the incidence of Type 2 diabetes by up to 58% (2).
Factors that may increase your risk of developing diabetes
As we get older, we tend to become less active. Consequently, many individuals notice that aging is accompanied by weight gain (typically stored around the abdomen and upper body).
A more sedentary lifestyle and the subsequent weight gain result in the body’s insulin becoming less effective (this is known as ‘insulin resistance’). This contributes to the prevalence of Type 2 diabetes in people over age 65 (it currently affects 1 of 5 in this population).
2. Weight and Body Mass Index (BMI)
Body Mass Index (BMI) is a health measure based on an individual’s height and weight. A BMI of 20-25 indicates a healthy weight range. A BMI over 25 is considered overweight.
However, weight is only part of the equation. Of more importance is body composition i.e the ratio of muscle to fat, and where that fat is stored. Fat stored around the upper body or abdomen is associated with an increased risk of high blood pressure, high blood fats (cholesterol and triglycerides) and diabetes.
3. Impaired glucose tolerance (IGT)/ Impaired fasting glucose (IFG)
Impaired Glucose Tolerance (IGT) occurs when the blood glucose level is higher than normal, but not high enough to be classified as diabetes. Sometimes referred to as pre-diabetes, a third of people with IGT/ IFG will develop diabetes (unless lifestyle changes are made).
4. Gestational diabetes
Up to 8% (3) of pregnant women will develop gestational diabetes. Blood glucose levels usually return to normal after the birth; however, these women are at increased risk of Type 2 diabetes in the future.
5. Family history
A family history of diabetes is a serious risk factor. If an individual has one parent with Type 2 diabetes, they’re more than twice as likely (4) to develop the condition than those without a family history.
How Life Insurance Companies View Diabetics
Diabetes is a particularly complex condition to underwrite. The type of diabetes, the treatment and control, and the presence of any multitude of complications will all have an impact on the assessment.
To make a qualified decision, there are several considerations that must be taken into account.
1.The type of diabetes?
Type 1 diabetes (‘insulin-dependent diabetes mellitus’ or IDDM) is generally more serious over the long-term than Type 2 (‘non-insulin dependent diabetes mellitus’ or NIDDM).
Impaired Glucose Tolerance (IGT) is also a warning sign that an applicant is highly likely to develop diabetes. Caution must be exercised accordingly.
2. Age at diagnosis
The younger a person is when they develop diabetes, the worse the long-term outlook for suffering complications of the disease. Consequently, the underwriter must consider the applicant’s age, and when the condition was diagnosed.
Glucose levels can be ‘labile’ – that is, they can fluctuate greatly in a relatively short period of time. For this reason, the underwriter will request that a fasting MBA20 be performed (even a glass of orange juice before the test can cause a spike in the glucose level reading).
Diabetes is associated with a host of medical complications. These include blindness, kidney dysfunction, peripheral vascular problems and even diabetic coma. An underwriter assessing a diabetic will usually write to the treating doctor to confirm details of treatment, control, and any complications with the condition.
Trauma insurance for diabetics
An applicant with a stable and managed case of diabetes can usually be offered life insurance (which may be subject to a loading). Trauma insurance and TPD insurance may be available for diabetics depending on the age of diagnosis and degree of control (premiums are also typically subject to a loading).
If you are diabetic and seeking trauma insurance, we can help you find cover and compare trauma insurance quotes to ensure you have the most competitively priced policy for your situation.
1. January 2005 Prevention of Type 2 Diabetes: A Background Paper Diabetes Prevention Working Party
2. Type 2 Diabetes Risk Evaluation for Men and Women Aged 40-49 Years at High Risk of Type 2 Diabetes Australian General Practice Network, MBS item 713
3. 2009, Diabetes Australia, www.diabetesaustralia.com.au
4. 2008, Diabetes Australia VIC, www.diabetesvic.org.au
Source: ING August 2010