• Posted March 23, 2026

Insurance Lapses Play Havoc With Diabetes Management, Study Shows

People with type 2 diabetes struggle to control their disease if their insurance coverage is shaky, a new study says.

Low-income adults who experience insurance “churn” – losing coverage off and on – have poorer blood sugar control and need more diabetes meds than those whose insurance coverage remains steady, researchers reported March 20 in JAMA Health Forum.

“Even though they all started at the same baseline, the patients who lost insurance had worse outcomes,” said lead researcher Nathalie Huguet, an associate professor of family medicine at Oregon Health & Science University in Portland.

“They needed more medications and that raises a big question: How can people manage complex diabetes treatment without coverage?” Huguet said in a news release.

These results have dire implications for millions of Americans who face loss of insurance due to Medicaid cuts and rising insurance premiums that have taken place under the Trump Administration, researchers said.

“Many people who lose Medicaid don’t regain coverage for a long time,” Huguet said. “Marketplace plans are expensive, and insulin is still unaffordable for many people without insurance.”

For the new study, researchers tracked health records for more than 39,000 adults treated at community health centers across 20 states. These centers largely serve people living at or near poverty.

Results showed there were increases in insulin use and other high-intensity diabetes treatments among patients who lost insurance.

Serious complications from undertreated diabetes were less common, but that might reflect the fact that follow-up in this study was relatively short, Huguet said.

“Serious complications like amputations or kidney failure don’t happen overnight,” she said. “What we’re seeing is an early warning sign. The disease gets harder to manage after insurance loss.”

Her colleague, Dr. Jennifer DeVoe, a professor of family medicine at OHSU, warned that if Medicaid coverage shrinks, clinics will struggle to care for these patients.

“We need to increase support to primary care clinics so they can continue to serve their patients and keep the damage of losing insurance to a minimum,” she said in a news release.

Huguet suggested the consequences for uninsured people could be severe.

“People without insurance are more likely to end up in the emergency department,” she said. “That can lead to life-changing outcomes, like amputations, and it ultimately costs more for patients and the entire health system.”

More information

The National Institutes of Health has more on managing diabetes.

SOURCE: Oregon Health & Science University, news release, March 20, 2026