Receipt of Diabetes Specialty Care and Management Services by Older Adults with Diabetes in the United States, 2015–2019

Objective: We characterized the receipt of diabetes specialty care and management services among older adults with diabetes. Research Design and Methods: Using a 20% random sample of fee-for-service Medicare beneficiaries ≥65 years, we analyzed cohorts of T1D, T2D with history of severe hypoglycemia (HoH), and all other T2D annually from 2015-2019. Outcomes were receipt of office-based endocrinology care, diabetes education, outpatient diabetes health services excluding those provided in primary care, and any of the aforementioned services. Results: In the T1D cohort, receipt of endocrinology care and any service increased from 25.9% and 27.0% in 2015 to 32.7% and 34.7% in 2019, respectively. In the T2D with HoH cohort, receipt of endocrinology care and any service were 13.9% and 14.6% in 2015, with minimal increases. Age, race/ethnicity, residential setting, and income were associated with receiving care. Conclusions: Findings suggest many older adults may not receive specialty care and underscore health disparities.