Adding Insult to Insulin: Can Diabetics Get Life Insurance?
What is Diabetes? Diabetes is a condition in which the body fails to produce enough insulin, or fails to process insulin normally. Can Diabetics get life insurance? Of course, however, there are some guidelines and restrictions as a result of secondary issues from irregular pancreas function.
Insulin is normally produced in the pancreas. It allows your body to use sugar/glucose for energy. And, if you have more glucose than needed it helps store it in your liver, which can then be used later. Insulin helps maintain a ‘healthy’ sugar level. If the sugar is not processed properly it can build up in the bloodstream to become too low.
Too much sugar (hyperglycemia) can cause long-term complications affecting your eyes, kidneys, nerves, and heart.
Diabetes Type I vs. Diabetes Type II
Type I Diabetes, sometimes referred to as Juvenile Diabetes, is a chronic condition in which the pancreas produces little or no insulin.
Type II Diabetes sometimes referred to as adult-onset or non-insulin dependent diabetes, is a condition in which your cells don’t use insulin properly.
Some Statistics from American Diabetes Association
1 out of 11 Americans has diabetes
1 out of 4 diabetics don’t know they have it
1 out of 3 adult Americans is prediabetic
Of those with prediabetes 9 of 10 do not know they are prediabetic
What is the estimated cost of a life insurance policy For Someone with Diabetes?
Type II diabetes ratings will depend heavily upon the level of control they demonstrate. Control is important because Diabetes is a progressive disease that can be slowed by meticulous control of blood sugar, weight control, and exercise. Diabetes control is monitored by testing glycosylated hemoglobin in the blood and by home monitoring of blood sugar. Normal glycosylated hemoglobin is a value of <6. Levels above 8 are evidence of poor control.
Expected rating based on age of onset assuming decent blood sugar control
|Age onset||Rating table range||Age – $100,000 20 year term annual premium|
|31-45||Table 4 to 8||Age 31 – $250 to $350|
|46-50||Table 2 to 8||Age 46 – $600 to $800|
|50+||Standard to Table 3||Age 50 – $430 to $680|
What do life insurers want to know in order to make an offer for life insurance?
- Type of Diabetes – type 1, type 2
- Age at onset – the longer the duration, the higher the risk
- Age at policy issue
- Control – Hemoglobin A1C is the gold standard to determine control (a test for glycosylated hemoglobin in the blood)
- Type of treatment – diet, oral medication, insulin shots, insulin pump
- Presence of other health conditions that either exacerbate diabetes or may be caused by diabetes; such as coronary artery disease, peripheral vascular disease, cerebrovascular disease, diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, proteinuria, foot issues (ulcers, etc.)
A little more about complications
As I mentioned earlier, too much sugar (hyperglycemia) can cause long-term complications affecting your eyes, kidneys, nerves, and heart. The complications appear to be a result of the damage that is done to the blood vessels. There is evidence to suggest that hyperglycemia reduces the level of the chemical compound nitric oxide. Nitric oxide is a vasodilator – meaning it helps the smooth muscles cells within the blood vessel wall to relax which then allow the vessel to widen and allow more blood flow.
Coronary Artery Disease
Type II Diabetes seems to go hand-in-hand with coronary artery disease. There is evidence to suggest that many of the same risk factors contribute to both diabetes and coronary artery disease.
- High Blood Pressure. There are studies that suggest that having both high blood pressure and diabetes can double the risk for cardiovascular disease.
- High Cholesterol. Diabetics tend to have high cholesterol levels. Excess cholesterol can build up in arteries, including arteries of the heart (coronary arteries). Cholesterol, fat, and other substances form plaque in the arteries. When some plaque breaks off a blood clot forms around the plaque. If the clot blocks a coronary artery it will prevent oxygen and other nutrients from reaching some heart muscle. This heart muscle cells will suffer injury and may die – resulting in a heart attack (myocardial infarction).
- Physical Build. Obesity is prevalent both among diabetics and people with coronary artery disease, and high blood pressure.
- Exercise. Lack of physical activity is associated with obesity, high blood pressure, diabetes and coronary artery disease.
Diabetic Retinopathy (eye damage)
High sugar levels can damage blood vessels in the retina. It may cause some to swell, leak, or even close. Ultimately this can cause obscured vision or even blindness.
Diabetic Nephropathy (diabetic kidney disease)
According to The Mayo Clinic, up to 40 percent of people with diabetes develop diabetic kidney disease. The extra blood sugar associated with diabetes can adversely affect the kidney’s ability to remove waste and extra fluids from the body. This extra waste can then build up in the blood and cause other health problems such as fluid in the lungs and changes in blood chemistry.
Diabetic Neuropathy (nerve damage)
It is thought that prolonged exposure to blood sugar may impair nerve cells’ ability to transmit signals. Additionally, the small blood vessels that supply oxygen and nutrients to the nerves can be damaged. These damaged vessels may not be able to meet the requirements of the nerve cells. Nerve problems can lead to a host of other problems like loss of limb, joint damage, urinary tract infection, digestive problems, and more.
Of particular concern is cardiac autonomic neuropathy (CAN), CAN affects the autonomic nerve fibers of the heart that regulate many heart functions. It can cause several disorders:
- resting tachycardia
- asymptomatic myocardial ischemia (reducing blood flow to the heart muscle) and infarction (obstructed blood supply that causes the death of tissue)
There seems to be a link between Alzheimer’s and diabetes. The culprit, once again, seems to be damaged blood vessels caused by hyperglycemia. Vascular dementia is caused by reduced or blocked blood flow to the brain. Additionally, if nerve cells are damaged (see diabetic neuropathy above) it can have a negative effect on cognitive function.
How do life insurers find out about your health condition
- Age of onset – the older the better as diabetes has had less time to do damage.
- Treatment – Diet control and oral medications are viewed more favorably than insulin treatment.
- Control – Blood tests will look at hemoglobin A1c, which give an indication of blood sugar levels over an extended period of time (2 to 3 months). Additionally, there are other readings that may indicate complications such as kidney disease. Medical records from your doctor will also be requested in order to determine control, complications, and treatment compliance.
How to shop for the most favorable life insurance plan
Many life insurers do not look favorably on anybody with diabetes. However, there are enough companies that have significant experience with this condition to be able to get multiple tentative offers. An experienced independent agent should know what questions to ask in order to get reliable tentative offers. This information will allow various companies to quickly evaluate any particular case and make educated offers. Of course, the real offer will depend on the medical records, labs, and other health conditions.
The bottom line
It is not unusual for someone with late-in-life-onset diabetes who can demonstrate good control and has no complication to be able to get a standard rate for life insurance.