Access to Diabetes Care: Issues, Resources, and Solutions

Treating and managing type 2 diabetes can depend on access to care. Access to care means being able to get effective, affordable healthcare when it's needed. A person's background, where they live, and their income are all factors that can affect how diabetes is managed.

This article covers access to care issues for people living with type 2 diabetes, including health insurance, healthcare affordability, and government and non-profit resources for getting care.

What Are Access to Care Issues?

Access to care issues are barriers that prevent a person from getting healthcare in a timely fashion. There are four requirements for complete access to care:

• Coverage: Having affordable health insurance
• Services: Access to screening and preventative care
• Timeliness: Getting healthcare when it is needed
• Workforce: Access to healthcare professionals who are qualified and understand a person's specific needs

Care access can be affected by various factors, including:

• Race or ethnicity: Black Americans are twice as likely to be diagnosed with diabetes than White Americans. Experts have found that systemic racism is a major cause of this disparity.
• Income: Lower-income people are twice as likely to be diagnosed with type 2 diabetes.
• Location: Living in a rural area can make it more difficult to access care for type 2 diabetes. Living in more polluted areas makes it more likely for a person to be diagnosed with type 2 diabetes.
• Food insecurity: Not having access to nutritious foods like fresh fruit and vegetables can increase a person's risk for diabetes.
• Insurance: High co-payments for screening and treatment, along with high prescription drug costs, can make it more harder for people to manage or treat type 2 diabetes.
• Education: Education about type 2 diabetes is a key part of prevention and management. Patients who receive education about type 2 diabetes have a 25% chance of managing the disease, compared to 10% among people who do not receive this education.

Diabetes Health Care

About 40% of Americans develop diabetes at some point in their lives. Complications of the condition disproportionately burden the overall healthcare system.

Creating equal access to type 2 diabetes healthcare and prevention can include the following steps:

• Policies limiting co-pays and prescription drug costs for type 2 diabetes and its complications
• Low-cost or free insurance policies that cover preventative care and education
• Outreach to populations at a greater risk of type 2 diabetes (e.g., communities of color and people with lower incomes)
• Access to green spaces and exercise centers
• Local sources of affordable nutritious food (e.g., fresh vegetables and fruits)
• Addressing environmental hazards like pollution and unclean water, which have been linked to a higher likelihood of diabetes

Affordability and Insurance Obstacles

Health insurance and coverage can greatly affect type 2 diabetes diagnosis and treatment. For example:

• People living with type 2 diabetes who are uninsured could face a 168% increase in emergency room visits.
• About half of people with type 2 diabetes remain undiagnosed, but people without insurance are 5% to 10% more likely to remain undiagnosed.
  
• People with insurance could be 18% less likely to have undiagnosed type 2 diabetes, while people with Medicaid could be 25% less likely.
• Insurance costs can be more than double for people living with type 2 diabetes.
• Among people with health insurance, about 27% of people with type 2 diabetes remain undiagnosed because of inadequate screening services.

According to The National Clinical Care Commission (an organization that researches chronic diseases that burden the U.S. healthcare system), insurance policies should cover the following to help people prevent and treat type 2 diabetes:

• Type 2 diabetes treatments without deductible requirements or copayments
• Screening for type 2 diabetes
• Lifestyle changes with the intention of treating diabetes
• Systems to monitor blood sugar levels at home
• Prescription drugs for type 2 diabetes and related conditions (e.g., kidney disease or heart conditions)

Diabetes Care Resources

There are ways to supplement your diabetes care, whether or not you have insurance, such as getting help from local, national, and international organizations. These organizations can be a path toward becoming an advocate for yourself and your community.

Local

Local resources for getting help with type 2 diabetes management might include:

• Federally funded healthcare clinics found using the U.S. Department of Health & Human Services' Find a Health Center tool
• Prescription discount cards from pharmacists, doctors, and drug companies
• The YMCA's Diabetes Prevention Program, which provides support groups and classes
• The American Diabetes Organization Community Connection for local resources like nutrition classes, physical activity programs, and educational resources
• Local community center programs funded by the Centers for Disease Control and Prevention
• Recreation centers or churches with type 2 diabetes support groups

If local groups are unavailable, online groups like Beyond Type 2, Smart Patients, and Diabetes Daily can help you connect to other people living with diabetes.

National

National programs can also help with healthcare costs and connecting with others who have the disease. These include:

• NeedyMeds provides information about non-profit organizations that can help with healthcare services like lab testing, prescription drug coverage, and lifestyle support.
• Healthwell Foundation provides assistance with co-pays for children living with type 2 diabetes.
• The Patient Advocate Foundation (PAF) Diabetes Fund provides assistance with co-pays, premiums, and prescription drug costs.
• National organizations like the American Diabetes Organization and Lion's Club provide grants for starting local support and advocacy groups

International

The International Diabetes Federation (IDF) and Lion's Club International are worldwide organizations that provide educational resources, advocacy guidance (e.g., participating in or organizing a World Diabetes Day event), support groups, screening events, and funding for community initiatives.

Ongoing Diabetes Management

Managing type 2 diabetes is an ongoing process that usually includes a team of people, including your healthcare providers, loved ones, and support groups. Management methods include:

• A nutritious diet and regular exercise to manage your weight and prevent complications
• Taking medication if needed to help stabilize your blood sugar
• Regular blood sugar screening and testing at home
• Recognizing signs of blood sugar changes
• Managing stress and getting enough sleep
• Connecting with others who are managing type 2 diabetes in your community or online

Summary

Access to care, or being able to get healthcare when needed, can affect type 2 diabetes treatment and management. Barriers to accessing care include a person's background, income, and education. For example, communities of color and people with lower incomes are less likely to have health insurance. Prevention steps—which can include everything from yearly checkups to living near green spaces safe for walking—also affect health outcomes.

There are government and community organizations that can supplement or provide type 2 diabetes care. Federally-funded healthcare clinics and organizations like the Lion's Club, YMCA, and the American Diabetes Association, as well as local community centers, can provide resources like care, education, and support groups.

A Word From Verywell

Treating and managing type 2 diabetes can seem overwhelming, but there are resources you can turn to for health. Going to federally-funded low or no-cost clinics, joining a diabetes support group or management program in your community, and asking your pharmacist about prescription discount cards are just some ways you can get type 2 diabetes care for yourself and others. If access to care barriers exist for your community, joining local diabetes organizations can be a great way to advocate for changes like lower prescription drug costs and exercise facilities in your area.