Research Description

Background: The COVID-19 pandemic complicated the delivery of routine diabetes care since priorities in the care delivery were changing. Telehealth became widely available to anyone in Illinois in 2020. It is not clear how patients keep up with the management of diabetic foot, retinopathy, nephropathy, neuropathy, obesity, or control their glycemic status in changing environments. An investigation is needed to identify barriers to access condition management observed during the COVID era and develop engagement strategies to overcome them. Hypothesis: (1) Authors hypothesize that the COVID-19 might affect the management of diabetes comorbidities differently due to a variation in culturally accepted fluency with novel technology, and the ability to cope with the progression of the disease. (2) For selected conditions, need for in-person care might lead to fewer positive effects of telehealth. Supporting rationale: Disrupted routine diabetic foot management leads to 10.8 times higher odds for patients to end up with non-traumatic lower extremity amputation. African Americans are four times more likely to experience diabetes-related amputation than Whites. Specific aims are: (1) Identify disparities in diabetes management; (2) Analyze potentially good places and barriers to conducting intervention in the communities; (3) Co-design and create suitable approaches for future patients/community practice engagement to improve outcomes in areas with significant diabetes mismanagement. Research design: The analysis of medical records from different communities will be complemented by the experience of patient/community engagement experts who worked in these communities. Relevance to the treatment of diabetes: Community-specific solutions to improve diabetes treatment will be produced.