As the government shutdown stretches into its fifth week, it’s forcing furloughed government workers to evaluate how they will continue to pay for basic necessities like food, rent and healthcare. Due to the unexpected nature of the shutdown, and its length, some federal workers have begun crowdsourcing donations to raise money for their medications, while others have resorted to selling valuables and other possessions to make up the cash.

However, coupled with the other bills, even these alternative means of fundraising aren’t always enough. Some have decided to ration the amount of insulin they use, even if that means risking death.

“When [my blood sugar] gets that high, you can go into diabetic ketoacidosis, you can go into a coma,” furloughed Department of Interior employee Mallory Lorge told NBC News. “I can’t afford to go to the ER. I can’t afford anything. I just went to bed and hoped I wake up.”

Read more: Rent Or Insulin? The Rising Cost Of Diabetes Meds Forces Patients Into Difficult Choices

For Lorge, the shutdown has exacerbated an issue she and the 9.4 percent of Americans afflicted with diabetes have had to struggle with in recent years: Insulin costs are growing so large they’re becoming unbearable. Between 2012 and 2016, insulin prices for patients suffering from Type 1 diabetes nearly doubled from $2,864 to $5,705 on average, according to a new report by the nonprofit organization Health Care Cost Institute.

Some have pointed to the problem lying in the fact that there is no generic version of insulin, and that three companies produce 93 percent of the world’s insulin.

“It’s the moral scandal of 2019 right now — the high price of insulin and people going off it,” Art Caplan, director of the Division of Bioethics at New York University’s Langone Medical Center said on Boston Public Radio Wednesday. “We have ridiculous price inflation on insulin. Insulin’s been around since 1923, there’s no new insulin, not much has changed except the price has gone up a gazillion-fold, and it’s clearly monopolistic.”

Despite pressure from activists around the world and associations like the American Medical Association, which has called on the Justice Department and Federal Trade Commission to push for more transparency in insulin pricing, no firm has indicated they will bring down costs.

For now, those suffering from diabetes will have to manage with the raising costs of co-pays, which already average $300 to renew a prescription. And as the shutdown continues to loom over Washington, D.C. and the rest of the nation, the only thing those like Lorge can do is hope for the best.

“My husband and I were talking and saying, ‘Let’s just worry about each day. We can’t worry about our dreams now,’” Lorge said.