Younger Adults With Diabetes Report Low Receipt of Healthcare During COVID-19

November 23, 2021
Connor Iapoce

Connor Iapoce is an assistant editor for HCPLive and joined the MJH Life Sciences team in April 2021. He graduated from The College of New Jersey with a degree in Journalism and Professional Writing. He enjoys listening to records, going to concerts, and playing with his cat Squish. You can reach him at ciapoce@mjhlifesciences.com.

Adults aged 18–29 years (87%) with diabetes were more likely to report missed medical care during COVID-19, compared to those aged 30–59 years (63%) or ≥60 years (26%).

Although poorly managed diabetes is a risk factor for severe COVID-19, the extent of which the pandemic has affected diabetes care and management, particularly whether this factor is varying across age groups, remains unknown.

As a result, a team of investigators evaluated access to and use of health care, as well as attitudes, experiences, and behaviors on COVID-19 prevention and vaccination, through the administration of a non-probability, Internet-based survey during February - March 2021.

Led by Catherine E. Barrett, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, investigators observed that nearly 9 in 10 younger adults with diabetes, aged 18 - 29 years, reported delayed receipt of health care during the COVID-19 pandemic.

Methods

Out of 8,485 adults in the US who were eligible, a total of 5,261 (62.1%) completed the COVID-19 Outbreak Public Evaluation Initiative survey. From this number, 760 (14%) who reported diabetes currently managed by regular medication or treatment were included in the analyses.

The demographic variables for the study included age, sex, race/ethnicity, household income, education level, employment status, US Census region, and health insurance status.

Additionally, the experiences, attitudes, and behaviors related to COVID-19 included knowing someone with a positive test result of had died from COVID-19, perception of being at risk for severe COVID-19, vaccination intention, and a composite measure of support for and adherence of recommended COVID-19 prevention behavior.

Further, in regard to health care access and use, survey respondents reported if they had delayed or avoided medical care due to concerns related to COVID-19, as well as whether their ability to access care or medication was easier, harder, or unaffected as a consequence of the pandemic.

In the statistical analysis, weighted percentages and 95% confidence intervals were calculated by age group (18 - 29, 30 - 59, and ≥60 years). Data in the age groups showed 79 patients in the 18 - 29 years group, 372 patients in the 30 - 59 years group, and 309 patients in the ≥60 year group.

Findings

Investigators observed a larger proportion of younger adults with diabetes reported not knowing someone who had received a positive SARS-CoV-2 test result (90%), compared to adults aged 30 - 59 years (69%) or ≥60 years (57%), P <.001.

Younger adults reported lowest support for COVID-19 prevention guidelines (28%) and COVID-19 prevention behaviors (30%), compared to adults aged 30 - 59 years (62% and 64%, respectively; P <.001) and ≥60 years (51% and 72%, respectively; P <.001).

Additionally, younger adults reported having the lowest percentage of in-person health care appointments (53%), compared to those aged 30 - 59 years (76%) and ≥60 years (85%), P <.001.

Data show both adults aged 18 - 29 years (87%) and adults aged 30 - 59 years (63%) were more likely to report delayed health care, compared to adults aged ≥60 years (26%, P <.001).

Additionally, investigators observed adults with diabetes aged <60 years were less likely to report unaffected access to diabetes medications (44%, 18 - 29 years; 72%, 30 - 59 years), compared to adults aged ≥60 years (96%, P <.001).

Out of survey respondents with diabetes, 28%, 33%, and 17% of those aged 18–29 years, 30–59 years, ≥60 years, respectively reported that their health care was disrupted due to personal concerns that the health care system might be overwhelmed (P = .001).

Overall, the most common reason for disruption in care among younger adults was concern about becoming infected with SARS-CoV-2 (44%), which did not significantly differ from that of adults aged ≥30 years (31%, 30 - 59 years; 27%, ≥60 years, P = 0.151).

Takeaways

Barrett and colleagues concluded younger adults with diabetes reported the lowest receipt of health care during the COVID-19 pandemic. They noted most of these patients did not consider themselves at risk for severe COVID-19 with the lowest engagement in preventive behaviors.

“During the COVID-19 pandemic, efforts to enhance access to diabetes care for adults with diabetes and deliver public health messages emphasizing the importance of diabetes management and COVID-19 prevention, including vaccination, are warranted, especially in younger adults,” investigators wrote.

The study, “Health Care Access and Use Among Adults with Diabetes During the COVID-19 Pandemic — United States, February–March 2021,” was published by the CDC.


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