COVID-19 Impact on Diabetes Management (iNPHORM, USA)

Abstract

This American study quantifies how and the extent to which glycemic management has suffered due to COVID-19, nearly one year after the first USA-based case was detected. This cross-sectional study evaluates a real-world cohort of Americans (≥18 years old) with type 1 or type 2 diabetes (T1D, T2D) taking insulin and/or secretagogues (iNPHORM study, January 2021). A sample of 772 respondents was analyzed (T1D: 18.9%; male: 49.5%; age: 52.1 [SD: 14.5]). Prevalence of confirmed COVID-19 was 9.3% (March 2020 to January 2021). Nearly 25% reported the COVID-19 situation made affording rent/living expenses somewhat/much harder, while 18.8% struggled to ensure adequate food supply to avoid hypoglycemia. Challenges paying for medications or test strips/sensors were reported by 17.4% and 16.2% of respondents, respectively; while 17.4% experienced issues retrieving therapies and >10% rationed their diabetes medications. Participants reported difficulties remembering to take their diabetes medications (11.6%), test their blood glucose (12.5%), and monitor their hypoglycemia risk (12.5%). One quarter thought the pandemic impeded their ability to consult with diabetes care providers. Several (11.4%) felt less in control of their hypoglycemia, with 16.0% reporting insufficient social support to help manage events. Over a third struggled to stay as physically active as usual. The pandemic was found to cause substantial deficiencies in diabetes self-management and routine care. Results will be instructive for handling diabetes management during the current public health emergency and in future.