Category Life Insurance

Living with diabetes comes with a high financial cost

11 November 2021 Sirago Underwriting Managers
Blood glucose meter

Blood glucose meter

Diabetes is not just a physically and emotionally debilitating disease, it also holds significant financial burdens for people living with it.

These financial burdens relate to aspects such as lifetime healthcare and medication costs, the significant lifestyle and dietary changes needed to manage the disease, lost productivity due to diabetes complications that cause higher levels of absenteeism and reduced work capacity, and the higher cost of or even unavailability of life insurance due to the increased mortality and morbidity risks posed by diabetes.

According to data from the International Diabetes Federation (IDF), in 2019 approximately 463 million adults (20-79 years) were living with diabetes; by 2045 this will rise to 700 million.¹ The proportion of people with type 2 diabetes is increasing in most countries, including South Africa, driven by rapid urbanisation, changes in eating habits and more sedentary lifestyles – factors significantly amplified by the COVID-19 pandemic.¹

‘The direct medical cost of type 2 diabetes mellitus in South Africa’ study² conducted to estimate the direct medical costs associated with T2DM in the South African public health sector showed that in real terms, the cost of all T2DM cases in 2030 is estimated to be R35.1 bn. In a separate study – ‘A total cost perspective of type 1 and 2 diabetes mellitus in two South African medical schemes servicing the public healthcare sector’ – showed that direct and indirect costs combined to medical schemes accrued to R27.9 billion (R19 675 per patient) in 2015 and R29.9 billion (R21 197 per patient) in 2016.³

“These staggering numbers do not consider the multitude of indirect, yet no less onerous, costs that people living with diabetes face, and which increase with disease severity. One area of financial security that is significantly impacted by how well the condition is managed is life insurance. While life insurance is a fundamental and foundational support to most peoples’ financial wellbeing and security, for many people living with diabetes, getting life insurance can be a very expensive, and in some instances, impossible exercise,” says Martin Rimmer, CEO of Sirago of Underwriting Managers.

Consider the implications of a family breadwinner not being able to protect their family from financial hardship through a life insurance solution in the event of their untimely death, or unable to own their own home as they are unable to cede their life insurance as surety for the bank’s risk in providing a home loan.

Solving the life insurance conundrum for people living with diabetes
The reality is that even if someone is managing their diabetes reasonably well, they may get life cover, but it typically comes at a loading of anywhere between 25-400% on the premium that a person of similar age and lifestyle, without diabetes, could expect to pay. This has significant implications for the affordability of life cover, as well as the amount of cover available.

It is this dilemma that Sirago hopes to solve with its new ‘Diabetic Life’ insurance product that provides for an effective diabetes management tool within the cover as a means to providing financial relief.

“What was missing from insurance programmes until now was the ‘how’ to achieve good control. Until now, people living with diabetes faced many challenges in how to achieve good control in a manner that directly impacts their financial planning and costs in a positive and tangible manner.

Diabetic Life’ addresses this glaring gap and is the only insurance product that embeds a comprehensive and scientifically proven diabetes management programme into the policy benefits, at no additional cost to the policyholder. Adherence to and participation in the programme which is facilitated and administered by Guidepost in South Africa is mandatory to keep cover in place, with the objective of helping policyholders improve their diabetes control over the long term and in doing so, maintain market related life-insurance premiums, better cover and ultimately, a better quality of life,” explains Rimmer.

Why does good control matter?
Most, if not all complications of diabetes are often preventable if blood sugar levels are kept as close to normal as possible – the goal being an HbA1C level below 8%. From an insurance and risk perspective, good control and consistency is what insurance underwriters look for, not only at the time of application, but throughout the term of the cover. With the ‘Diabetic Life’ insurance solution, people living with diabetes get access to clinically proven diabetes self-management education and support – covering behavioural, educational, psychosocial, and clinical aspects of living with and managing diabetes for optimal health outcomes.

“For someone living with diabetes, it’s a win-win on two fronts – they get access to affordable and comprehensive life insurance which provides the financial security which has been lacking for too long, but most crucially, they get all of this by being able to live their very best, fullest and healthiest life with a scientific diabetes management support programme that does not cost them more,” concludes Rimmer.

This Product is administered by Sirago Underwriting Managers (Pty) Ltd an Authorised Financial Services Provider (FSP:4710) and is underwritten by Guardrisk Life Limited, a licensed Life Insurer and Authorised Financial Service Provider (FSP:76). For more information go to

1. Diabetes Facts & Figures. International Diabetes Federation. Accessed 3 Nov 2021 at
2. Erzse A, Stacey N, Chola L, Tugendhaft A, Freeman M, Hofman K. The direct medical cost of type 2 diabetes mellitus in South Africa: a cost of illness study. Glob Health Action. 2019;12(1):1636611. doi: 10.1080/16549716.2019.1636611. PMID: 31282315; PMCID: PMC7012049. Accessed 3 Nov 2021 at

A M Opperman, M de Klerk. A total cost perspective of type 1 and 2 diabetes mellitus in two South African medical schemes servicing the public healthcare sector. South African Medical Journal 2021;111(7):635-641. DOI:10.7196/SAMJ.2021.v111i7.15169 Accessed 3 Nov 2021 at

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