Care Disrupted in Young Adults With Diabetes During COVID-19

Miriam E. Tucker

November 22, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Almost 9 in 10 younger adults with diabetes experienced disruptions in healthcare during the COVID-19 pandemic, new data from the US Centers for Disease Control and Prevention (CDC) suggest.

In a survey of 760 adults with medication-treated diabetes, younger adults with diabetes were more likely than older people with the condition to report experiencing disruptions in healthcare during the pandemic and to engage less in efforts to prevent SARS‑CoV‑2 transmission, including vaccination.

The data were published November 19 in Morbidity and Mortality Weekly Report by Catherine Barrett, PhD, an epidemiologist in the CDC's Division of Diabetes Translation, and colleagues.

"Efforts are warranted to enhance access to diabetes care during the COVID-19 pandemic, and to deliver public health messages emphasizing the importance of diabetes management and COVID-19 prevention, including vaccination, especially among younger adults with diabetes," the authors write.

The 760 patients with medication-treated diabetes were among a larger nationwide sampling of adults who completed the COVID-19 Outbreak Public Evaluation Initiative, an internet-based survey administered by Qualtrics in February and March 2021.

Younger adults (aged 18-29) were significantly less likely to report having health insurance (77%) compared with those aged 30-59 (91%) or 60 years and older (97%).  

Those aged 18-29 and 30-59 were more likely to report diagnosed mental health conditions, including depression, anxiety, and posttraumatic stress disorder compared with those aged 60 and older (86%, 64%, and 32%, respectively). 

Younger adults were significantly more likely to believe that they weren't at high risk for severe COVID-19, including 94% of those aged 18-29 and 76% of those aged 30-59, compared with just 52% of those aged 60 and older. The youngest group was also less likely than older adults to practice COVID-19 prevention behaviors including mask-wearing, physical distancing, and avoiding gatherings, at just 30% compared with 64% of the middle-aged and 72% of the oldest group.

Patients declaring that they intended to be vaccinated were 66% of those aged 18-29 years, compared with 77% of 30- to 59-year-olds and 85% of those aged 60 and older.  

The youngest group was also the least likely to have had in-person medical appointments (53%), compared with 76% of the middle-aged group and 85% of those age 60 years and older. Both younger groups were more likely than the oldest to report delayed healthcare (87%, 63%, and 26%, respectively).  

"These data show that almost 9 in 10 younger adults with diabetes delayed healthcare. Diabetes is a serious health condition that puts people at risk for heart attack, stroke, blindness, amputations, and other serious diabetes complications. Early treatment and diabetes management can help prevent or delay diabetes-related health conditions and improve overall health," Barrett told Medscape Medical News.

Barrett said that use of telehealth didn't significantly differ by age group, ranging from 40% to 51%.

"Telehealth is important for continuity of care for people living with diabetes, but it's important for patients to continue to receive routine in-person care as well, particularly for obtaining up-to-date labs and other tests for prevention of diabetes complications," she noted.  

Information about diabetes type wasn't included.

"The assessment did not collect information on insulin use, age of diagnosis, or self-report of diabetes type, so it was not possible to distinguish between type 1 and type 2 diabetes. It is likely that, among the younger adults in our study, type 1 diabetes was more common than type 2 diabetes, although type 2 is on the rise among younger adults as well," Barrett said.

The investigators plan to repeat the survey with nationally representative data that will be available in 2022.

Barrett is a CDC employee and has reported no relevant financial relationships.

MMWR Morb Mortal Wkly Rep. 2021;70:1597-1602. Full text

Miriam E. Tucker is a freelance journalist based in the Washington, DC, area. She is a regular contributor to Medscape, with other work appearing in The Washington Post, NPR's Shots blog, and Diabetes Forecast magazine. She is on Twitter: @MiriamETucker.

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