Barriers to Type 2 Diabetes Care and Access

Treating and managing type 2 diabetes can depend on access to care, meaning the ability to get effective, affordable healthcare when it’s needed.

Factors that could reduce access to care include where a person lives, their income, and health insurance. While finding care can sometimes seem overwhelming, there are local and national groups that can help provide resources for those who need them.

What Are the Barriers?

For complete access to care, you need affordable health insurance and access to timely care and qualified health professionals.

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 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 information.

Insurance Barriers

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.

Improving Access to Diabetes Care

Improving access to type 2 diabetes healthcare means finding ways to reduce disparities caused by factors like income and location. About 40% of Americans develop diabetes at some point in their lives, and complications of the condition disproportionately burden the overall healthcare system.

Some of these methods to improve public health may include:

• 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

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 intended to 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)

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.

Resources for Help

Treating and managing type 2 diabetes can seem overwhelming, but there are resources you can turn to for health, such as:

• Going to federally funded low or no-cost clinics
• Joining a diabetes support group or management program in your community
• Asking your pharmacist about prescription discount cards

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.

There are also 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 Support: Some local resources for getting help with type 2 diabetes management might include:

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

International Resources: 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.

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.