Telehealth use among US adults with type 2 diabetes: differences in medication fill patterns and care processes

The expansion of telehealth following the COVID-19 pandemic has enhanced access to care, but questions remain about how well telehealth supports the delivery of comprehensive, guideline-concordant care for type 2 diabetes.

We conducted an observational cross-sectional study using nationally representative survey data from the 2021-2023 Medical Expenditures Panel Survey to make unadjusted descriptive comparisons between adults with any diabetes-related telehealth use and those receiving only in-person diabetes care.

Of 4348 respondents who had at least one visit for type 2 diabetes from 2021 to 2023, 90.7% had only in-person visits, whereas 9.3% had ≥1 telehealth visits. Insulin prescriptions were more common among telehealth users compared to nonusers (47.5% [95% CI, 41.0%-54.1%] vs 34.4% [95%CI, 32.1%-36.7%]).

Overall, this study provides current national data on patterns of telehealth use among US adults with type 2 diabetes. Differences in insulin prescription fill patterns may reflect greater clinical complexity and care needs among patients who use telehealth. These findings offer important context for policy-makers and health systems as they evaluate the role of telehealth in managing chronic disease and consider how virtual care models can be implemented while maintaining high-quality diabetes care.