Health Care Disparities in Outpatient Diabetes Management During the Coronavirus Disease 2019 Pandemic: Where Do We Stand Now?
Authors' conclusion
While the frequency of health measurements had not fully recovered 2 years into the pandemic, this did not translate to worse diabetes management or a widening of pre-existing disparities. Our study emphasizes the role of equitable health care in minimizing inequalities in diabetes, particularly during times of crisis.
Study context
- Population
- Adults with diabetes in an endocrinology practice, across 3 periods: T1 (March 2019-February 2020), T2 (March 2020-February 2021), T3 (March 2021-February 2022)
- Exposure
- Diabetes outpatient management across 3 time periods: prepandemic (T1) vs pandemic years (T2, T3)
- Outcome
- Frequency of HbA1c, BMI and SBP measurements
Methodological detailssingle endocrinology practice
- Single endocrinology practice
Main finding
As reported in the abstract
Reduction in T2 vs prepandemic: HbA1c, body mass index (BMI), systolic blood pressure (SBP)
36.0%, 46.3%, 48.5%
Still lower at end of study period vs prepandemic: HbA1c, BMI, SBP (P < .001)
8.7%, 13.4%, 15.2%
Observational data: associations, not effects.
Further findings
Average HbA1c and LDL-C
- Average HbA1c and LDL-C slightly improved
Clinic appointments per patient
- Increased during the pandemic, fueled by telehealth utilization
Disparities
- Women had fewer in-person visits during T2
- Age >65 had better HbA1c
- Most socioeconomically deprived had worst HbA1c in every period
- Black patients had worse HbA1c, LDL-C and SBP throughout, not worsening over the pandemic
Original publication
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