COVID-19's impact on type 1 diabetes management: A mixed-methods study exploring the Peruvian experience

Area of Science:

• Public Health
• Endocrinology
• Health Services Research

Background:

• The COVID-19 pandemic severely disrupted healthcare services globally, particularly in low- and middle-income countries.
• Access to chronic condition management, such as for Type 1 diabetes mellitus (T1DM), was significantly impacted.

Purpose of the Study:

• To describe the challenges encountered by individuals with T1DM in accessing healthcare during the COVID-19 pandemic in Peru.
• To analyze the Peruvian health system's response to T1DM care continuity during the pandemic.

Main Methods:

• A sequential explanatory mixed-method study conducted from May to September 2020.
• Quantitative data collected via electronic surveys from 105 people with T1DM, 50 caregivers, and 76 health professionals.
• Qualitative data gathered through 31 in-depth interviews with patients, healthcare providers, and a Ministry of Health representative.

Main Results:

• Individuals with T1DM experienced difficulties accessing consultations, insulin, monitoring devices, and laboratory tests.
• Peru's health system response evolved from initial informal local initiatives to a formal Ministry of Health strategy focusing on primary care, teleconsultations, and medicine delivery.
• Patient associations played a crucial role in organizing support and mitigating the pandemic's impact on T1DM care.

Conclusions:

• The Peruvian healthcare system demonstrated slow adaptation to the pandemic's demands for T1DM care.
• Despite system adaptations, significant access barriers for people with T1DM persisted.
• Urgent reinforcement of inter-level communication, teleconsultations, and medicine delivery is recommended, alongside integrating patient associations into the health system response.