It’s well know that people with diabetes — both type 1 and type 2 — are at a higher risk for poor outcomes related to COVID-19, including a higher risk of hospitalization and death. But the current pandemic doesn’t just affect the health of people with diabetes who develop COVID-19, as shown by a new survey from the American Diabetes Association (ADA).
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The survey, conducted in partnership with Thrivable and Diabetes Daily, aimed to cover a representative sample of the 34 million Americans living with diabetes. It shows that as the pandemic has wrought widespread economic and personal financial damage, many people with diabetes have developed new challenges to their medical care and self-care that may put them at higher risk for complications of the very virus causing the pandemic — as well as at higher risk for diabetes complications in the future.
Reduced access to food, drugs and supplies
The new survey, outlined in an ADA press release, shows a crisis in access to many key aspects of diabetes care, including food, drugs, blood glucose testing supplies and health insurance.
One of the most alarming findings is that the pandemic has dramatically reduced access to food. More than one in four respondents said that the pandemic has reduced their ability to access healthy food, and one in five rely now in some form of nutrition assistance, such as the federal Supplemental Nutrition Assistance Program (SNAP or food stamps), or a local food bank. Among those receiving nutrition assistance, 46% said that the food they’re getting isn’t good for diabetes management. About one in five respondents said they can’t eat as frequently as they need to eat for effective diabetes management, and one in five also say that they’ve been forced to choose between buying food and drugs or medical supplies.
Access to healthcare has also been hurt by the pandemic. Even though delaying routine care hasn’t been recommended, 43% of respondents said they had done so since the start of the pandemic, often out of fear of exposure to the virus that causes COVID-19. And one in five respondents said they had skipped or put off getting access to technology to help manage their diabetes, such as an insulin pump or continuous glucose monitoring (CGM) system. Financial hardship was the most common reason given for not pursuing these technologies.
Among insulin pump or CGM system users, 15% said they had delayed getting refills for supplies during the pandemic, with 70% giving financial hardship as the reason.
Since the start of the pandemic, 12% of respondents experienced disruption in their health insurance status, often due to a personal job loss or the job loss of a spouse or someone else providing them insurance. This number represents only insurance loss, and doesn’t include people who already lacked insurance at the start of the pandemic. Among those who lost their insurance, 19% turned to Medicaid (the joint federal–state insurance program for low-income people) for coverage, while 13% became uninsured. The rest reported eventually getting some other form of health insurance.
More telemedicine use, increased openness to vaccine
One potentially hopeful finding of the survey was that people with diabetes are more open to getting a COVID-19 vaccine than the general population, with 37% saying they planned to get it as soon as possible. People with diabetes were less than half as likely to say they would never get the vaccine than the general population.
In a trend that may have long-term implications for diabetes care, respondents reported using telemedicine at a rate seven times higher than before the start of the pandemic, with 73% reporting some form of a virtual visit during the pandemic. Among those who had used telemedicine, 40% said it made diabetes management easier for them, and more than half said they planned to keep using telemedicine once the pandemic is over.
One notable finding from the survey is that people with diabetes were far more likely than the general population to report having voted in the 2020 U.S. presidential election. A remarkable 89% of respondents said they voted, a rate that’s 35% higher than that of the general population. Among those who voted, 58% said they did so remotely, such as by mail or by using a ballot drop box.