There is a pandemic of type 2 diabetes (T2D) in the United States (U.S.). We know that racial and ethnic minorities have higher rates of pre-diabetes and T2D. To help, Medicare Diabetes Prevention Programs (MDPP) have provided support to Medicare recipients since 2018. These programs provide evidence-based education to encourage health behavior changes to prevent type 2 diabetes. A huge number of people – 61 million (almost half of all people on Medicare) – are thought to have prediabetes and need these programs.

Diabetes education works, but access is not easy

The Centers for Medicare & Medicaid Services (CMS) recently reported data on access to diabetes prevention programs (DPP). They compared states by their rates of current diabetes and by race and ethnicity. Overall, they found that there were 1.5 places that provided DPP for every 100,000 Medicare recipients. There were 3 states (Connecticut, New Mexico and Washington, D.C.) that only had 1 place offering DPP for about every 215,000 people on Medicare.

Racial and ethnic bias in accessing diabetes prevention programs

States with over 20% Black Medicare recipients also have some of the nation’s highest T2D rates. However, except for Maryland which had 30 sites, many of these states only had 1 to 3 sites that offered DPP. Similarly, many states with over 20% Hispanic/Latino Medicare recipients had few sites offering DPP and low enrollment of Hispanic/Latinos. For example, while New Mexico’s Medicare population is over 20% Hispanic/Latino, only 1 site provided DPP.

Inequity in diabetes education

These findings suggest that the supply of diabetes education does not meet demand for services, especially for racial and ethnic minorities. There is an urgent need to increase access to diabetes education. Ways to do this include expanding types of suppliers and encouraging innovations in service delivery, especially in resource-poor areas. A common theme in diabetes care in the U.S. is that access to evidence-based services is a major challenge for those most likely to benefit.


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