In 2019, KJZZ News reported on growing concerns about insulin shortages for the world’s growing population of diabetics, which are disproportionately represented by Native Americans and Hispanics.

Now, new research in the journal Annals of Internal Medicine shows troubling rates of insulin rationing.

A representative sample from the 2021 National Health Interview Survey suggests up to 1.3 million people ration their insulin, typically by delaying purchasing or reducing dosage.

Self-limiting was highest among older adults and people who were uninsured, although the rate among young people was twice that of seniors over 65.

Many reported feeling overwhelmed by the demands of living with diabetes, one of which is likely rising insulin cost: The Inflation Reduction Act, which caps co-pays at $35 a month, only applies to people on Medicare.

That group had the study’s lowest rates of insulin rationing.