Health Inequities Increase Challenges for Diabetic Patients During COVID-19

November 4, 2021 | Stericycle Communication Solutions

Food or necessary medical supplies? Which one can you afford today? Nurses, physicians, and social workers are all too aware of the heartbreaking choice that many patients face. Encouraging patients to pursue services, procure medical supplies, and make lifestyle changes is a daily battle for frontline providers who care for patients with chronic conditions like diabetes.

Learn how we can help identify and engage Medicare enrollees who have not  taken advantage of Medicare Nutritional Counseling or DSMT.

But when COVID-19 struck, many diabetic patients failed to seek necessary care—either because doctors' offices were closed or because they feared contracting the virus. Additionally, diabetes patient education classes and support groups also stopped. Some patients didn't get blood drawn for regular A1C readings. Others didn't have smartphones or reliable internet connectivity to take advantage of telehealth options.

Devasting Impact of COVID-19 on Diabetes Patients

COVID-19 has had an especially devastating effect on the 34 million Americans with diabetes—and the millions more with prediabetes, at high risk of diabetes, or with undiagnosed diabetes. Even more, a diabetes diagnosis was identified as one of the risk factors of developing COVID-19.

Already at risk for nerve damage, cardiovascular and kidney disease, foot and limb injuries, vision problems, and other complications, people with diabetes are more likely to have serious complications from COVID-19, according to the American Diabetes Association.

In addition, COVID-19 fatalities are high among people with diabetes: "The U.S. Centers for Disease Control and Prevention (CDC) cites research showing that 40% or more of the people who died with COVID-19 also had diabetes, according to Reuters." But it wasn't just COVID-19 that took the lives of diabetes patients. Diabetes-related deaths in the U.S. rose faster in 2020 than any other disease among leading causes of death.

Reuters conducted an intensive investigation into COVID-19 and diabetes that revealed: "Deaths from diabetes surged 17% to more than 100,000 last year, based on a Reuters' analysis of CDC data. Younger people – those ages 25 to 44 – suffered the sharpest increase, with a 29% jump in deaths. By comparison, all other deaths except those directly attributed to the coronavirus rose 6% last year."

Pandemic Limits Access to Care and Healthy Food for Diabetes Patients

Even for patients with diabetes and prediabetes who don't contract COVID-19, the financial and economic toll of the pandemic has created barriers to proper diabetes management. A report by Thrivable and the American Diabetes Association reveals that many patients with diabetes struggle to access medications, devices, insurance, and food that they need to properly manage their disease.

One in 5 people says they have foregone or put off getting the technology they need to manage their diabetes, like an insulin pump or continuous glucose monitor (CGM). Most often, this is due to financial constraints.

Of those who use a CGM or insulin pump, 15% report they have delayed refilling needed supplies during the pandemic. 70% of them say that's due to financial constraints or hardship.

The challenge extends beyond accessing medical care or supplies. Access to healthy food is a problem for more than 1 in 4 people, according to the survey.

Nearly 1 in 5 say they must now rely on some sort of nutrition assistance, and a third of those individuals now lean on local food banks for themselves and their families.

Nearly half of those who rely on nutrition assistance say the food they're getting is not good for their diabetes, and 1 in 5 say they aren't able to eat as frequently as they need to effectively manage their diabetes.

Nearly 1 in 5 people say that they have had to choose between buying food, medications, or medical supplies—and those in lower-income brackets are more likely to be affected. Some of these patients ration their medications and limit doctor visits to avoid out-of-pocket costs. But delays in care can exacerbate poor health outcomes—including the loss of a limb or even a loss of life.

For many diabetes patients, delays in care and limited access to healthy food were new challenges, but for other underserved and vulnerable populations, access challenges are a constant reality--pandemic or not.

Increased Prevalence of Diabetes in Patients from Underserved Populations Highlights Health Inequity

The COVID-19 pandemic also helped to shed light on health inequity. Although diabetes affects an estimated 1 in 10 Americans, it affects Black, Indigenous, and People of Color (BIPOC) communities at higher rates.

American Indians/Alaska Natives




Non-Hispanic Black


Non-Hispanic Asian People




Source: The Centers for Disease Control and Prevention (CDC)

Health systems and providers have a responsibility to help all patient populations with diabetes live healthier lifestyles, change behavior, and manage diabetes through nutrition.

Health Inequities Point to the Need for Increased Advocacy

The disproportionate toll of diabetes on minority, low-income, and historically underserved Americans helps to showcase the systemic inequities in American healthcare. That's why the American Diabetes Association and other leading organizations support the Health Equity Bill of Rights.

This bill aims to make diabetes drugs, devices, supplies, and health insurance more accessible for Americans regardless of race, income, zip code, age, education, or gender. While creating a future without unjust health disparities is a complex issue, one solution health systems can focus on now is improving health literacy among patients and driving action through effective engagement.

Conduct Diabetes Patient Education Campaigns and Programs

Increasing patient education efforts are critical to improving health outcomes. Programs that educate patients on the importance of lifestyle changes could lessen the severity of diabetes and other related diseases. November is American Diabetes Month, making it the perfect time to conduct educational outreach to patients and connect them with resources that can help better manage their diabetes.


Fewer than 5% of Medicare beneficiaries use their 10 to 12 hours of diabetes self-management training benefit which can cover individual and group sessions providing tips for eating healthily, being active, monitoring blood sugar, taking medications, and reducing risks.

Source: Kaiser Health News


Part of Stericycle Health & Wellness Campaigns, our Diabetic Nutritional Counseling helps health systems identify and engage Medicare enrollees who have not taken advantage of Medicare Nutritional Counseling or DSMT. This includes conducting multichannel outreach campaigns, scheduling appointments, and educating patients on the steps required to obtain a doctor's order to ensure the benefit is covered. Download our Diabetic Nutritional Counseling data sheet to learn more.

Learn how we can help identify and engage Medicare enrollees who have not taken advantage of Medicare Nutritional Counseling or DSMT.

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