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In the latest indication of how some people are struggling to afford their medicines, a new survey finds that 18% of people who have diabetes around the world rationed their insulin at least once last year, but this occurred among nearly 26% of people with diabetes in the U.S.

And while 70% reported having some coverage for their costs, two-thirds noted they have no financial support for the remaining out-of-pocket costs. In the U.S., 89% of people with diabetes had health care coverage, but 79% had no other form of assistance. Just 5.5% received government assistance, according to the survey by T1International, a patient advocacy group that focuses on Type 1 diabetes.

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By contrast, rationing was reported among just 6.5% of people with diabetes in other high-income countries and almost 11% of those living in low or middle-income countries.

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