Background and Objective:
During Covid-19, health and coverage restrictions, increased healthcare system demands, and patient uncertainty were important barriers to uninterrupted diabetes care. Diabetes patients are solely responsible for managing their disease through on-time access to care, proper diet, glucose monitoring, and medication. The present study was designed to examine the effect of socioeconomic variables such as employment and insurance change, on patient-self-reported delays in access to medical care, difficulties obtaining medication, forgoing CGM/Insulin pump (and refilling), for diabetes patients in the US, during the pandemic.

Methods:
This cross-sectional study used secondary data of 2,595 U.S. diabetes patients (December 2020, thrivable survey). The analysis examined associations between insurance change and type, employment, income, and patient education, with the following outcomes: (i) delay in care, (ii) difficulties in obtaining medications, (iii) foregoing CGM/Pump, (iv) forgoing refilling CGM/Pump. Bivariate statistics were first conducted, followed by multivariate analysis using binary logistic regression in spss.

Results:
Patients with recent insurance status changes were 1.5 times more likely to report delays in care, 33% more likely to experience difficulties obtaining medication, twice more likely to forego CGM/Insulin pump, and four times more likely to forego refilling CGM/Insulin pump. Those with a recent employment change were 1.5 times more likely to have delays in care and difficulties obtaining medication, while those without insurance were twice as likely to have difficulty obtaining medication. Education, unemployment, and income were also found to be associated with challenges in seeking diabetes care.

Conclusion:
Diabetes patients experienced challenges during the pandemic, which can be attributed, to an extent, to socioeconomic factors. Statewide policies need to be established for non-delayed access to diabetes care in times of crisis, such as during the recent pandemic.