But in the background, a silent and deadly epidemic caused by a familiar disease that has been exacerbated by COVID-19 is killing tens of thousands. That is diabetes.

More than 100,000 Americans died from diabetes for the second straight year in 2021, as prices of the life-saving treatment insulin continue to soar and more and more people are left scrambling to afford it. 

In 2019, diabetes was the seventh-leading cause of death in the U.S., accounting for 87,647 deaths. Since then, deaths from diabetes went up 17% in 2020 and 15% in 2021 compared to pre-pandemic levels, and they surpassed a record-high level 100,000 deaths in each of the last two years, according to a Reuters analysis of Centers for Disease Control and Prevention death data, the accuracy of which the CDC confirmed. 

It’s alarming news to the 34 million people who are living with Type 1 or Type 2 diabetes in the U.S. 

According to the American Diabetes Association, people suffering from diabetes are at an elevated risk of developing serious reactions to COVID-19, including hospitalization and death. Of the nearly 880,000 Americans who have died from COVID-19, roughly 40% were diabetics. 

But experts say the rise in deaths from diabetes in the U.S. is also due to how expensive the government is allowing insulin to get.

“Patients literally need to decide if they will pay for their insulin or for their housing and food,” said Dr. Irl B. Hirsch, a professor at the University of Washington School of Medicine in a December interview with Fortune. “Insulin should be readily available to anyone who needs it.”

Diabetes has long been the country’s most expensive chronic disease—in part because of the direct cost of its treatment, and also because it contributes to other diseases like kidney disease and high blood pressure, according to the ADA. Diabetics represent just 10% of the population, but account for 25% of all health care spending in the U.S. and 33% of prescription drug spending, according to the ADA. 

That’s due in part to the historically high price of insulin—90% of which is supplied by three companies: Eli Lilly, Sanofi, and Novo Nordisk. In the U.S., insulin costs on average roughly 800% more than in other developed economies. While it’s unclear how many diabetics die directly due to a lack of insulin, data reviewed by Fortune suggests it’s at least a few per day.

Addressing the diabetes epidemic has received increasing attention from members of both political parties in recent months.

President Joe Biden’s Build Back Better act, which passed the House in November but has hit a roadblock in the Senate, includes a provision that would limit  the out-of-pocket copay cost of insulin to $35 a month.

“Nobody has held the manufacturing — the manufacturers accountable, until now,” Biden said during a White House press briefing in December. “Whether you get health insurance through your private policy, the Affordable Care Act Marketplace, or through Medicare…Nobody is going to pay more than $35 each month for insulin.”

And earlier this month, the National Clinical Care Commission submitted a report to Congress suggesting the country adopt a more holistic approach to preventing Americans from developing type 2 diabetes, which is the most common form and is most likely to occur from being overweight, inactive, and over age 45, according to the ADA. 

The federally appointed panel recommended the government create an Office of National Diabetes Policy to coordinate nationwide efforts.

“Diabetes in the U.S. cannot simply be viewed as a medical or health care problem, but also must be addressed as a societal problem that cuts across many sectors, including food, housing, commerce, transportation and the environment,” the commission wrote in its Jan. 5 report to Congress.