Diabetes has become one of the most urgent public health challenges worldwide. According to the WHO, the number of people living with diabetes surged from 200 million in 1990 to 830 million in 2022. In 2021 alone, diabetes and related kidney disease were responsible for over 2 million deaths. Additionally, high blood glucose contributed to around 11% of cardiovascular fatalities. 

Despite the severity of these numbers, diabetes remains a condition that can be effectively managed. In many cases, its complications can be prevented or delayed with timely interventions such as proper diet, medication, and consistent screening.

However, for underserved communities, access to these essential resources is often limited, creating a widening care divide. Addressing this gap requires targeted strategies that ensure equitable access to prevention, management, and treatment services.

The Burden of Diabetes in Underserved Communities

Underserved communities, whether in rural regions or low-income urban neighborhoods, carry a disproportionate burden of diabetes due to systemic barriers. Limited access to health insurance, affordable medications, and nutritious food often leads to delayed preventive screenings and inconsistent follow-up care. 

Transportation challenges and the absence of local healthcare facilities further widen the gap, leaving many individuals vulnerable to uncontrolled diabetes. This often results in severe complications such as neuropathy, kidney disease, cardiovascular issues, and even preventable deaths.

The consequences extend far beyond individual health, reflecting a massive economic toll. According to the American Diabetes Association, the economic costs of diabetes in the U.S. in 2022 reached $412.9 billion. Of this, $306.6 billion was attributed to direct medical costs, while $106.3 billion stemmed from indirect costs such as lost productivity. 

These figures underscore how addressing diabetes in underserved communities is both a healthcare imperative and a matter of social and economic equity.

The Role of Education in Strengthening Diabetes Care

Effective diabetes management in underserved communities begins with patient education and awareness. Many individuals lack a full understanding of how diet and lifestyle impact their blood sugar, a problem often compounded by low health literacy.

The CDC emphasizes that Diabetes Self-Management Education and Support (DSMES) is essential, yet only about 50% of adults with diabetes report having access to it. This is a significant gap, as people who receive diabetes education are far more likely to adopt healthy behaviors like daily blood sugar monitoring. 

They are also more consistent with preventive clinical care, including A1C tests, annual eye exams, and flu shots. In fact, nearly 25% of those who received this education followed at least 9 of 10 recommended self-care and clinical practices. In comparison, only 10% of those who did not receive it achieved the same level of adherence.

Expanding access to culturally sensitive diabetes education can therefore reduce complications, enhance self-reliance, and improve long-term outcomes.

Expanding the Healthcare Workforce to Improve Access

A critical step in closing the diabetes care gap in underserved communities is addressing workforce shortages, particularly in primary care. Many rural and low-income areas lack enough physicians, leaving patients without timely access to essential services. Nurses often step in to fill these gaps, but their practice can be limited. 

MSN to FNP programs are an effective solution, enabling registered nurses to transition into advanced roles where they can provide comprehensive primary care. Family nurse practitioners (FNPs) are trained to manage chronic conditions such as diabetes, prescribe medications, and guide patients on lifestyle changes. Their presence improves access, reduces hospitalizations, and enhances patient outcomes. 

According to Rockhurst University, becoming an FNP also offers professionals greater flexibility, higher salaries, and personal fulfillment. In addition, the ability to pursue a more traditional work schedule makes these programs valuable for patients and for healthcare providers.

Community-Based Models for Improved Care

Managing diabetes in underserved communities requires more than expanding the workforce; it demands innovative, community-based care models. Mobile clinics, telemedicine platforms, and community health centers are examples of approaches that bring healthcare closer to those who might otherwise go without it.

Partnerships between healthcare organizations, local nonprofits, and government agencies can further extend the reach of diabetes management programs. By providing free screenings, affordable medications, and nutritional support, such collaborations directly address the socioeconomic barriers that hinder effective care. 

Importantly, community-based solutions increase trust. People are often more willing to engage with healthcare professionals who are visibly present in their neighborhoods.

Technology as a Tool for Access

Technology holds immense potential for bridging the diabetes care divide, especially through telehealth and mobile health apps. These tools enable patients to consult with providers remotely and manage their condition with features like glucose tracking and medication reminders. However, a significant barrier exists in the form of the digital divide.

The NIH highlights that the financial burden of technology, including the cost of internet access, is a major challenge. In the U.S., Black and Hispanic/Latino individuals, along with those in rural areas, have lower access to high-speed internet. For a person with diabetes, internet connectivity is a “super” social determinant of health, a prerequisite for managing their condition. 

While some solutions exist, such as using cellular technology for data uploads, a lack of private space for virtual appointments also poses a barrier. To truly maximize the benefits of health technology, it’s essential to ensure equitable access to both devices and reliable internet.

Addressing Social Determinants of Health

Effective diabetes management is impossible without tackling the social determinants of health. These include factors such as income, education, housing stability, and access to nutritious food. Many underserved communities are “food deserts,” where fresh fruits and vegetables are scarce, and unhealthy, processed foods dominate. 

Healthy eating is shaped not only by access to safe and affordable foods but also by consumer knowledge, preferences, and cultural practices. 

Unfortunately, most people in the U.S. do not consume enough fruits, vegetables, whole grains, dairy, seafood, or healthy oils. Instead, diets are often high in saturated fat, sodium, and added sugars, patterns that deviate significantly from federal dietary recommendations.

Addressing these gaps requires community-driven solutions such as affordable produce markets, food pantries, and culturally appropriate meal-delivery programs. Alongside this, policies that expand insurance coverage and subsidize medications and testing supplies are vital. A holistic approach ensures diabetes care extends beyond prescriptions to everyday living conditions.

FAQs

How can diabetes be prevented in the community?

Preventing diabetes in the community involves promoting healthy lifestyles through balanced diets, regular physical activity, and weight management. Education on risk factors, early screening, and accessible healthcare services is essential. Additionally, creating supportive environments with affordable, nutritious food and safe spaces for exercise fosters long-term prevention and community well-being.

Why is type 2 diabetes more common in underserved communities?

Type 2 diabetes is more common in underserved communities due to limited access to healthcare, nutritious foods, and safe spaces for physical activity. Economic challenges, higher stress levels, and a lack of preventive care further worsen risks. These barriers make early detection, consistent management, and healthy lifestyle choices harder to achieve.

What is the national diabetes prevention program?

The National Diabetes Prevention Program (NDPP), led by the CDC, aims to prevent or delay type 2 diabetes in adults at risk. It offers structured lifestyle-change programs emphasizing healthy eating and regular physical activity. These programs also focus on behavior modification, providing participants with guidance and practical tools to lower their diabetes risk.

Bridging the diabetes care divide in underserved communities requires more than medical treatment. It demands education, workforce expansion, technology, and social support. By addressing systemic barriers, patients gain equitable access to timely, effective care. Together, these efforts can transform diabetes outcomes and promote healthier, stronger communities.

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