The Impact of COVID-19 on Access to Insulin and Other Supplies among Patients with Diabetes

Purpose: Diabetes is a well-researched primary prevalent comorbidity among patients infected with COVID-19; however, there is little literature on the management of Type 2 diabetes during government-mandated quarantine periods. To our knowledge, there is no literature assessing the impact of COVID-19 on diabetic management in an underserved population in the outpatient or ambulatory care setting. The PROMIS (Partnership in Resilience for Medication Safety) research team was tasked to understand how diabetes was managed in the outpatient setting in an underserved patient population. Our study objective is to explore the impact COVID-19 had on patient access to insulin, other diabetic therapeutics, and diabetic supplies in the outpatient setting. Our secondary objective is to describe if differences in diabetic management occurred between patients who utilized telehealth vs inpatient appointments. Methods: A retrospective analysis of deidentified claims data from HSC Health and John Peter Smith (JPS) Health Network was performed. Hemoglobin A1c (HgbA1c), type of visit (telehealth vs in-person), and number of appropriate diabetic management changes were compared between two cohorts, a pre-COVID-19 cohort (May 2019-April 2020) and a COVID-19 cohort (May 2020-July 2020). Adult patients were included in the study if they had at least one HgbA1c in both time periods. Controlled HgbA1c results were defined as < 7. Evaluation of appropriate diabetes was defined by the American Diabetes Association 2021 Standards of Medical Care in Diabetes guidelines. Results: Pending. Conclusion: Analysis of drug regimen changes, HgbA1c changes, and telehealth utilization between the cohorts will provide insight into access barriers and how changes to therapeutic regimens were implemented as a result. These important findings will shed light on the impact of COVID-19 on diabetes care and prompt value considerations for pharmacists, physicians and other health care professionals in their diabetic management.