Young people with diabetes are four times more likely to be hospitalized for mental health or substance abuse treatment than those who are free of the disease, according to a recent study by the Health Care Cost Institute that was analyzed by Kaiser Health News.

Hospitalization rates for 19-25 year olds suffering from mental health and substance abuse disorders were 68% higher in 2014 than two years before.

One senior HCCI researcher told Kaiser the rise may be due to more young people utilizing services under the Affordable Care Act, which allows children to stay on their parents’ medical insurance until they turn 26 years old, and eliminated insurance discrimination.

“We saw a big jump in employer-sponsored coverage for those young folks” in 2014 as well, the researcher told Kaiser.

Managing diabetes is also often stressful for young people, who must constantly monitor their blood sugar levels and carbohydrate intake, and be mindful of the medications they need to take.

Too, increasing medical costs are a major buzzkill for anyone with a chronic disease: The Institute found that per capita spending on people with diabetes reached $16,021 per person in 2014, almost $10,000 more per person than for people without diabetes.

And people with diabetes spent two-and-a-half times more out of pocket than those without diabetes.