According to the 2020 National Diabetes Statistics Report from the CDC, 34 million Americans, just over 1 in 10, have diabetes. 88 million Americans (1 in 3) have prediabetes. Whether your body simply does not produce insulin (Type 1) or no longer can use insulin properly (Type 2) the condition can often be managed through medication, proper diet, and exercise.

However, some people through no fault of their own, are not able to get the disease under control. A prolonged struggle with diabetes can cause kidney or heart damage. Consistently elevated blood sugar levels can cause diabetic neuropathy, where the excess sugar in the blood damages the walls of capillaries in the legs, feet, and sometimes the hands, causing tingling, numbness or burning pain. Healing processes slow and the lack of sensation in the feet can lead to chronic ulcerations that can become infected. Diabetics are also at risk of developing diabetic retinopathy, cataracts or glaucoma. Some people develop what is sometimes referred to as “brittle diabetes.” Such an individual might experience sudden swings between very low blood sugars (sometimes causing loss of consciousness or seizures) or very high blood sugar levels, which can cause a person to enter into diabetic ketoacidosis, a potentially life-threatening complication which usually requires hospital treatment.

Co-occurring diseases can complicate treatment. Severe depression, for example, may reduce a person’s ability to maintain a proper diet, get exercise or even take medication as prescribed. Poverty is an impediment to diabetic care, as foods high in carbohydrates are also often the cheapest foods available. Homelessness presents its own unique barriers. Insulin is sensitive to temperatures that are too high or too low. Homeless persons rarely have a refrigerator in which they can store their insulin.

Social Security analyzes disability caused by diabetes and related complications under the body system that the complications affect. For example, diabetic gastroparesis is analyzed under criteria developed for digestive system disorders. Damage of the heart caused by diabetes is analyzed under the cardiovascular system criteria. Some people may have damage to multiple systems caused by diabetes (neuropathy, kidney disease, and retinopathy, for example) that don’t expressly meet the criteria for disability in any single area of analysis, but when considered together are deemed to be so severe as to prevent that person from being able to sustain work activity. Like any other impairment, proving disability requires seeking out and receiving consistent care, documenting your symptoms with your doctor and following prescribed care.