Impact of the COVID-19 pandemic and control measures on type 2 diabetes care among South Asians: the perspective of healthcare providers in British Columbia, Canada
8 affiliations
- 1Division of Endocrinology, University of British Columbia, Vancouver, British Colombia, Canada.
- 2BC Centre for Disease Control, Vancouver, British Colombia, Canada.
- 3School of Population and Public Health, University of British Columbia, Vancouver, British Colombia, Canada.
- 4TLC Diabetes and Endocrinology, Surrey, British Colombia, Canada.
- 5BC Cancer Agency, Vancouver, Canada.
- 6Seattle Pacific University, Seattle, Washington, United States of America.
- 7Fraser Health, Surrey, British Colombia, Canada.
- 8Fraser Street Medical Clinic, Vancouver, British Colombia, Canada.
Abstract
Background: British Columbia is one of the most ethnically diverse provinces in Canada, with South Asians emerging as one of the fastest-growing ethnic minority groups, burdened by a high incidence of type 2 diabetes. During the COVID-19 pandemic, many healthcare services shifted to virtual care to minimize infection transmission. Given the limited understanding of how primary care physicians in BC adapted their diabetes care approaches and the consequent impact on patient experience, this qualitative study aims to explore the effects of pandemic-related control measures on primary care diabetes services in BC from the perspectives of general practitioners, focusing particularly on their South Asian patients. Methods: We conducted semi-structured interviews with ten primary care physicians serving large South Asian patient populations. Interviews explored the pandemic’s effects on care delivery, provider adaptations, and consequences for South Asian patients with diabetes. Sessions were held in person or via Zoom/Teams and transcribed verbatim. Transcripts underwent thematic content analysis to identify recurring themes and insights regarding barriers, adaptations, and recommendations to improve diabetes care. Findings: The COVID-19 pandemic disrupted diabetes care, shifting services to virtual care and interrupting routine monitoring. This transition impacted specific aspect of diabetes care that can best be provided in-person (e.g., foot examinations, blood pressure checks and lifestyle counselling). The pandemic compounded existing issues, e.g., cost, concerns with side effects, and medication compliance among South Asian patients. Physicians also observed a general rise in anxiety and depression during the pandemic among their patients. Older South Asian patients faced additional cultural, language, and digital barriers; physicians struggled to obtain timely Hemoglobin A1c (HbA1c) tests. For many patients, a significant reliance on pharmacists embedded within certain physician’s clinics, ensured an uninterrupted access to diabetes medication and supplies. Conclusion: The COVID-19 pandemic disrupted diabetes care, with some groups facing additional cultural, language, and digital barriers. Our findings highlight the need for primary care reforms: improved telemedicine and EMR infrastructure, and policies to support virtual care. Bridging the digital divide and implementing targeted supports are essential to minimize care disruption for vulnerable populations during future pandemics or similar crises and ensure equity.
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BibTeX
@article{mahmood2026impact,
title = {{Impact of the COVID-19 pandemic and control measures on type 2 diabetes care among South Asians: the perspective of healthcare providers in British Columbia, Canada}},
author = {Bushra Mahmood and Jia Hu and Tricia S Tang and Prince Adu and Zaeema Naveed and Naveed Z Janjua and Akshay Jain and Amandeep Nandra and Yasmin Banga and Arun Garg and Clara Iturra and Monica Garcha and Geoffrey McKee},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0359295},
url = {https://doi.org/10.1371/journal.pone.0359295},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of the COVID-19 pandemic and control measures on type 2 diabetes care among South Asians: the perspective of healthcare providers in British Columbia, Canada
AU - Bushra Mahmood
AU - Jia Hu
AU - Tricia S Tang
AU - Prince Adu
AU - Zaeema Naveed
AU - Naveed Z Janjua
AU - Akshay Jain
AU - Amandeep Nandra
AU - Yasmin Banga
AU - Arun Garg
AU - Clara Iturra
AU - Monica Garcha
AU - Geoffrey McKee
PY - 2026
DA - 2026/10/23
JO - PLOS One
DO - 10.1371/journal.pone.0359295
UR - https://doi.org/10.1371/journal.pone.0359295
AB - Background: British Columbia is one of the most ethnically diverse provinces in Canada, with South Asians emerging as one of the fastest-growing ethnic minority groups, burdened by a high incidence of type 2 diabetes. During the COVID-19 pandemic, many healthcare services shifted to virtual care to minimize infection transmission. Given the limited understanding of how primary care physicians in BC adapted their diabetes care approaches and the consequent impact on patient experience, this qualitative study aims to explore the effects of pandemic-related control measures on primary care diabetes services in BC from the perspectives of general practitioners, focusing particularly on their South Asian patients. Methods: We conducted semi-structured interviews with ten primary care physicians serving large South Asian patient populations. Interviews explored the pandemic’s effects on care delivery, provider adaptations, and consequences for South Asian patients with diabetes. Sessions were held in person or via Zoom/Teams and transcribed verbatim. Transcripts underwent thematic content analysis to identify recurring themes and insights regarding barriers, adaptations, and recommendations to improve diabetes care. Findings: The COVID-19 pandemic disrupted diabetes care, shifting services to virtual care and interrupting routine monitoring. This transition impacted specific aspect of diabetes care that can best be provided in-person (e.g., foot examinations, blood pressure checks and lifestyle counselling). The pandemic compounded existing issues, e.g., cost, concerns with side effects, and medication compliance among South Asian patients. Physicians also observed a general rise in anxiety and depression during the pandemic among their patients. Older South Asian patients faced additional cultural, language, and digital barriers; physicians struggled to obtain timely Hemoglobin A1c (HbA1c) tests. For many patients, a significant reliance on pharmacists embedded within certain physician’s clinics, ensured an uninterrupted access to diabetes medication and supplies. Conclusion: The COVID-19 pandemic disrupted diabetes care, with some groups facing additional cultural, language, and digital barriers. Our findings highlight the need for primary care reforms: improved telemedicine and EMR infrastructure, and policies to support virtual care. Bridging the digital divide and implementing targeted supports are essential to minimize care disruption for vulnerable populations during future pandemics or similar crises and ensure equity.
SN - 1932-6203
ER -