Clouds and Silver Linings: COVID-19 Pandemic Is an Opportune Moment to Democratize Diabetes Care Through Telehealth

Abstract

With the recent pivot to telehealth as a direct result of the COVID-19 pandemic, there is an imperative to ensure that access to affordable devices and technologies with remote monitoring capabilities for people with diabetes becomes equitable. In addition, expanding the use of remote Diabetes Self-Management Education and Support (DSMES) and Medical Nutrition Therapy (MNT) services will require new strategies for achieving long-term, effective, continuous, data-driven care. The current COVID-19 pandemic has especially impacted underserved US communities that were already disproportionately impacted by diabetes. Historically, these same communities have faced barriers in accessing timely and effective diabetes care including access to DSMES and MNT services, and diabetes technologies. Our call to action encourages all involved to urge US Federal representatives to widen access to the array of technologies necessary for successful telehealth-delivered care beyond COVID-19.

Dysglycemia in adults at risk for or living with non-insulin treated type 2 diabetes: Insights from continuous glucose monitoring

“…We have shown recently that the use of wearable technologies is both feasible and acceptable for this population [14]. To date, studies of CGM have overwhelmingly included White participants with T1D, with health insurance and high levels of education [41]. Also, recent data suggest that race and ethnicity may be independent factors influencing glycemic outcomes and the risk of complications associated with subgroups of adults with T2D [42].…”

Diabetes Technology Meeting 2020

“…Diabetes education is sometimes being omitted, which is critical to engaging patients and improving outcomes, particularly among patients with limited health literacy. 83 Additionally, in the United States, 1 in 4 Medicare beneficiaries lack digital access. 84 The disparities go deeper than that in diabetes; even though people of color shoulder a disproportionate burden of disease, they are a tiny proportion of patients who are included in the research and development process, and few of the clinicians that care for them are themselves from underserved communities.…”

The northeast glucose drift: Stratification of post-breakfast dysglycemia among predominantly Hispanic/Latino adults at-risk or with type 2 diabetes

“…3 Further, access to diabetes technology in the U.S. is also influenced significantly by race and ethnicity as well as social deprivation status. 4 To understand data derived from CGM profiles, a variety of metrics have been suggested. Average glucose and glucose variability measured over two weeks of CGM use provide an overall picture of glycemia in individuals.…”