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Stocker R, Gupta A, Taylor GS, Shaw JA, West DJ. Adapting to compromised routines: Parental perspectives on physical activity and health for children and adolescents with type 1 diabetes in the UK during COVID-19 lockdown. J Pediatr Nurs 2024; 77:e242-e250. [PMID: 38658303 DOI: 10.1016/j.pedn.2024.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To determine how COVID-19 lockdown impacted physical activity (PA) levels, wellbeing, and diabetes management in children (aged 0-17 years) with type 1 diabetes (T1D), from the perspectives of their parent/guardian. DESIGN AND METHODS This qualitative descriptive study is part of a larger, parallel mixed-methods design study, which incorporated a cross-sectional survey and semi-structured one-to-one interviews. Interviewees were recruited from the survey, which was distributed to parents of children/adolescents with T1D in the UK. Interviews explored diabetes management, mental and physical wellbeing, changes in PA levels, sleep quality before/during lockdown, and the effects of lockdown on the individual and their family. The interviews were transcribed and the data were analysed thematically. RESULTS 14 interviews were conducted with parents. Thematic analysis generated a central theme of routine disruption, with four further themes on diabetes management routines, harnessing the opportunities of lockdown, weighing up risk, and variable impact on wellbeing. CONCLUSIONS Maintaining or increasing PA during COVID-19 lockdown was associated with better diabetes management, sleep, and wellbeing for children/adolescents with T1D, despite significant disruption to established routines. Use of technology during the pandemic contributed positively to wellbeing. PRACTICE IMPLICATIONS It is crucial to emphasize the significance of maintaining a well-structured routine when treating patients with type 1 diabetes. A consistent routine, incorporating regular physical exercise and good sleep hygiene, will help with managing overall diabetes control.
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Affiliation(s)
- Rachel Stocker
- School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
| | - Alisha Gupta
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom; University Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-On-Tees TS19 8PE, United Kingdom.
| | - Guy S Taylor
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
| | - James A Shaw
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Daniel J West
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
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Ji W, Xie X, Bai G, He Y, Li L, Zhang L, Qiang D. Metabolomic approaches to dissect dysregulated metabolism in the progression of pre-diabetes to T2DM. Mol Omics 2024; 20:333-347. [PMID: 38686662 DOI: 10.1039/d3mo00130j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Many individuals with pre-diabetes eventually develop diabetes. Therefore, profiling of prediabetic metabolic disorders may be an effective targeted preventive measure. We aimed to elucidate the metabolic mechanism of progression of pre-diabetes to type 2 diabetes mellitus (T2DM) from a metabolic perspective. Four sets of plasma samples (20 subjects per group) collected according to fasting blood glucose (FBG) concentration were subjected to metabolomic analysis. An integrative approach of metabolome and WGCNA was employed to explore candidate metabolites. Compared with the healthy group (FBG < 5.6 mmol L-1), 113 metabolites were differentially expressed in the early stage of pre-diabetes (5.6 mmol L-1 ⩽ FBG < 6.1 mmol L-1), 237 in the late stage of pre-diabetes (6.1 mmol L-1 ⩽ FBG < 7.0 mmol L-1), and 245 in the T2DM group (FBG ⩾ 7.0 mmol L-1). A total of 27 differentially expressed metabolites (DEMs) were shared in all comparisons. Among them, L-norleucine was downregulated, whereas ethionamide, oxidized glutathione, 5-methylcytosine, and alpha-D-glucopyranoside beta-D-fructofuranosyl were increased with the rising levels of FBG. Surprisingly, 15 (11 lyso-phosphatidylcholines, L-norleucine, oxidized glutathione, arachidonic acid, and 5-oxoproline) of the 27 DEMs were ferroptosis-associated metabolites. WGCNA clustered all metabolites into 8 modules and the pathway enrichment analysis of DEMs showed a significant annotation to the insulin resistance-related pathway. Integrated analysis of DEMs, ROC and WGCNA modules determined 12 potential biomarkers for pre-diabetes and T2DM, including L-norleucine, 8 of which were L-arginine or its metabolites. L-Norleucine and L-arginine could serve as biomarkers for pre-diabetes. The inventory of metabolites provided by our plasma metabolome offers insights into T2DM physiology metabolism.
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Affiliation(s)
- Wenrui Ji
- Department of Endocrinology, The First People's Hospital of Yinchuan, Yinchuan, People's Republic of China.
| | - Xiaomin Xie
- Department of Endocrinology, The First People's Hospital of Yinchuan, Yinchuan, People's Republic of China.
| | - Guirong Bai
- Department of Endocrinology, The First People's Hospital of Yinchuan, Yinchuan, People's Republic of China.
| | - Yanting He
- Department of Endocrinology, The First People's Hospital of Yinchuan, Yinchuan, People's Republic of China.
| | - Ling Li
- Department of Endocrinology, The First People's Hospital of Yinchuan, Yinchuan, People's Republic of China.
| | - Li Zhang
- Department of Endocrinology, The First People's Hospital of Yinchuan, Yinchuan, People's Republic of China.
| | - Dan Qiang
- Department of Endocrinology, The First People's Hospital of Yinchuan, Yinchuan, People's Republic of China.
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van den Burg EL, Schoonakker MP, Korpershoek B, Sommeling LE, Sturm CA, Lamb HJ, Pijl H, Numans ME, Adriaanse MA, van Peet PG. Self-initiated lifestyle changes during a fasting-mimicking diet programme in patients with type 2 diabetes: a mixed-methods study. BMC PRIMARY CARE 2024; 25:148. [PMID: 38698355 PMCID: PMC11067095 DOI: 10.1186/s12875-024-02405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/24/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Lifestyle changes, especially regarding diet quality and physical activity, are important in the management of type 2 diabetes (T2D). This mixed-methods study explores self-initiated lifestyle changes in patients with T2D who followed a periodic fasting-mimicking diet (FMD). METHODS Quantitative data were obtained from the Fasting In diabetes Treatment trial (November 2018 to August 2021) in which 100 participants with T2D, using metformin only or no medication, were randomised to receive a monthly 5-day FMD for twelve months next to usual care, or usual care only. Diet quality and physical activity questionnaires were completed at baseline, six and twelve months. Changes over time were analysed using linear mixed models. Focus groups were organized with FMD participants to explore experiences regarding self-initiated lifestyle changes. The qualitative data was analysed using the Theoretical Domains Framework. RESULTS Questionnaires were available from 49 FMD participants and 43 controls. No differences in diet quality were found. Total physical activity in the FMD participants changed from 34.6 to 38.5 h per week (h/wk) from baseline to twelve months, while in controls it changed from 34.9 to 29.0 h/wk (between group difference, p = 0.03). In six focus groups with FMD participants (n = 20), individual participants perceived the FMD as an encouragement for (minor) lifestyle changes. There were no barriers to behaviour change related to the FMD. Important facilitators of healthy behaviour were an increase in awareness of the impact of lifestyle on health (knowledge), better physical fitness (physical) and health improvement (reinforcement). Facilitators unrelated to the FMD included family support (social influences) and opportunities in the neighbourhood (environmental context and resources), while barriers unrelated to the FMD were experiencing health problems (physical) and social events (social influences). CONCLUSIONS Using an FMD for five consecutive days per month did not affect diet quality in between FMD periods in quantitative analysis, but increased the number of hours per week spent on physical activity. Qualitative analysis revealed self-initiated improvements in both diet quality and physical activity in individual participants using an FMD. Healthcare professionals could use an FMD programme as a 'teachable moment' to stimulate additional lifestyle changes. TRIAL REGISTRATION ClinicalTrials.gov; NCT03811587. Registered 22 January 2019.
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Affiliation(s)
- Elske L van den Burg
- Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands.
| | - Marjolein P Schoonakker
- Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
| | - Bregje Korpershoek
- Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
| | - Lara E Sommeling
- Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
| | - Carlijn A Sturm
- Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Hanno Pijl
- Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
- Department of Internal Medicine, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Mattijs E Numans
- Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
| | - Marieke A Adriaanse
- Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
- Department of Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands
| | - Petra G van Peet
- Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
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Vilela LBF, Camargos LCDS, Rodrigues GR, Alves Júnior AA, Silva RCDD, Camargo Júnior EB. Sleep quality of patients with diabetes mellitus: association with anxiety trait and state. Rev Gaucha Enferm 2024; 45:e20230111. [PMID: 38477749 DOI: 10.1590/1983-1447.2024.20230111.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/21/2023] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVE To assess sleep quality and the association of trait and state anxiety in patients with diabetes mellitus. METHOD A cross-sectional, quantitative, and analytical study was conducted between January and April 2022, at the reference center for hypertension and diabetes in Rio Verde, Goiás, with 81 patients. The Pittsburgh Sleep Quality Index and State-Trait Anxiety Inventory were used for data collection. Analyses included the Student's t-test and multivariate logistic regression analysis. RESULTS Of patients, 64.2% reported poor sleep quality. There were significant differences in trait anxiety levels between patients with good and poor sleep quality. Trait anxiety was associated with sleep quality, with an increase in the trait anxiety score increasing the chances of poor sleep quality. CONCLUSION A significant proportion of the sample had poor sleep quality, and trait anxiety was found to be associated with this condition.
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Leite RO, Brodar KE, Saab PG, Marchetti D, Jaramillo M, Sanchez J, Davis E, Delamater AM, La Greca AM. Diabetes Care and Mental Health During the COVID-19 Pandemic: Perspectives of Adolescents with Diabetes, Parents, and Providers. J Clin Psychol Med Settings 2024:10.1007/s10880-023-09995-9. [PMID: 38281304 DOI: 10.1007/s10880-023-09995-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/30/2024]
Abstract
This study explored ways in which the COVID-19 pandemic impacted adolescents' diabetes management and psychosocial functioning, and how adolescents, parents, and providers viewed telemedicine. We present data from three studies: (1) a comparison of psychosocial functioning and glycemic levels before and after pandemic onset (n = 120 adolescents; 89% with type 1 diabetes), (2) an online survey of parents about pandemic-related stressors (n = 141), and (3) qualitative interviews with adolescents, parents, and medical providers about the pandemic's impacts on adolescents' diabetes care and mental health (n = 13 parent-adolescent dyads; 7 medical providers). Results suggested some adverse effects, including disrupting routines related to health behaviors and psychosocial functioning and impairing adolescents' quality of life. Despite these challenges, most participants did not endorse significant impacts. Some even noted benefits, such as increased parental supervision of diabetes management that can be leveraged beyond the pandemic. Furthermore, telemedicine offers benefits to continuity of diabetes care but presents challenges to care quality. These findings underscore the varied and unique impacts of the COVID-19 pandemic on adolescents with diabetes.
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Affiliation(s)
- Rafael O Leite
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA.
| | | | - Patrice G Saab
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA
| | - Daniella Marchetti
- Psychology Service, Bruce W. Carter Medical Center, Miami VA Healthcare System, Miami, FL, USA
| | - Manuela Jaramillo
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA
| | - Janine Sanchez
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eileen Davis
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Annette M La Greca
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA
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Hossen MT, Shuvo SD, Mazumdar S, Hossain MS, Riazuddin M, Roy D, Mondal BK, Parvin R, Paul DK, Adnan MM. Determinants of anxiety and depression among type 2 diabetes mellitus patients: A hospital-based study in Bangladesh amid the COVID-19 pandemic. Glob Ment Health (Camb) 2024; 11:e13. [PMID: 38390250 PMCID: PMC10882174 DOI: 10.1017/gmh.2024.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/14/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
Anxiety and depression are common psychological disorders in patients with type 2 diabetes mellitus (T2DM), which was upsurging worldwide amid the COVID-19 pandemic. This study aimed to explore factors associated with anxiety and depression among T2DM patients in Bangladesh during the COVID-19 pandemic. A cross-sectional study was conducted among T2DM patients using face-to-face interviews. Anxiety and depressive symptoms were measured using the CAS and PHQ-9 scales. Outcomes were assessed including sociodemographic, lifestyle, anthropometric, and challenges of getting routine medical and healthcare access-related questions. The prevalence of anxiety and depressive symptoms were 29.8% and 22.7%, respectively. Regression analysis reported that males older than 50 years, illiterate, unemployed or retired, urban residents, below the recommended level of moderate to vigorous physical activity (MVPA), low dietary diversity score (DDS) and obese respondents were associated with higher odds of anxiety and depressive symptoms. Moreover, respondents with transport difficulties, unaffordable medicine, medicine shortages, close friends or family members diagnosed with COVID-19 and financial problems during COVID-19 had higher odds of anxiety and depressive symptoms than their counterparts, respectively. Our study suggests providing psychological support, such as home-based psychological interventions, and highlighting policy implications to ensure the well-being of T2DM patients in Bangladesh during the pandemic.
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Affiliation(s)
- Md Toufik Hossen
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Sanaullah Mazumdar
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Md Sakhawot Hossain
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Md Riazuddin
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Deepa Roy
- Department of Mathematics, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Bappa Kumar Mondal
- Department of Food Fortification, Nutrition International, Dhaka, Bangladesh
| | - Rashida Parvin
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Dipak Kumar Paul
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
| | - Md Moshiuzzaman Adnan
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
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İlaslan E, Adıbelli D. Exploring Disease Management Experiences of Individuals with Type 2 Diabetes During the COVID-19 Pandemic: A Qualitative Study. Clin Nurs Res 2024; 33:51-59. [PMID: 37798953 DOI: 10.1177/10547738231201996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
The aim of this study was to investigate the impact of COVID-19 infection on disease management among individuals with type 2 diabetes and to explore their perspectives on COVID-19. This descriptive qualitative study included patients with diabetes, with a sample of 15 patients meeting the study criteria. The data were analyzed using code groups, which were then further categorized into main themes and subthemes. The main themes were: initial contact with the SARS-CoV-2 that is associated with COVID-19 illness changes in diabetes self-management behaviors; attempt at maintaining diabetes selfmanagement behaviors; and problems with accessing diabetes care. The study findings revealed several significant insights. Individuals with diabetes exhibited a fear of contracting SARS-CoV-2, which led to reduced levels of exercise and difficulties in managing blood sugar levels and insulin adjustments. Moreover, due to anxiety about COVID-19 infection, they postponed health check-ups, resulting in experiencing diabetes-related complications.
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Affiliation(s)
- Emine İlaslan
- Akdeniz University Kumluca Health Science Faculty, Antalya, Turkey
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8
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Alexander L, Yang C, Hugo H, Maria H, Stefan J, Åke L, Martin S, Staffan T, Cheng-Ting T, Jeanette W, Johan J. Anxiety, Depression and Quality of Life in Relation to SARS-CoV-2 Antibodies in Individuals Living with Diabetes During the Second Wave of COVID-19. DIABETES EPIDEMIOLOGY AND MANAGEMENT 2024; 13:100194. [PMID: 38463606 PMCID: PMC10923605 DOI: 10.1016/j.deman.2023.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Aims The objective was to compare anxiety, depression, and quality of life (QoL) in individuals living with type 1 (T1D) and type 2 (T2D) diabetes with matched controls during the second wave of the COVID-19 pandemic. Methods Via randomization, individuals living with diabetes T1D (n= 203) and T2D (n=413), were identified during February-July 2021 through health-care registers. Population controls (n=282) were matched for age, gender, and residential area. Questionnaires included self-assessment of anxiety, depression, QoL, and demographics in relation to SARS-CoV-2 exposure.Blood was collected through home-capillary sampling, and SARS-CoV-2 Nucleocapsid (NCP) and Spike antibodies (SC2_S1) were determined by multiplex Antibody Detection by Agglutination-PCR (ADAP) assays. Results Younger age and health issues were related to anxiety, depression, and QoL, with no differences between the study groups. Female gender was associated with anxiety, while obesity was associated with lower QoL.The SARS-CoV-2 NCP seroprevalence was higher in T1D (8.9%) compared to T2D (3.9%) and controls (4.0%), while the SARS-CoV-2 SC2_S1 seroprevalence was higher for controls (25.5%) compared to T1D (16.8%) and T2D (14.0%). Conclusions A higher SARS-CoV-2 infection rate in T1D may be explained by younger age and higher employment rate, and the associated increased risk for viral exposure.
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Affiliation(s)
- Lind Alexander
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Cao Yang
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hesser Hugo
- School of Behavioural, Social and Legal Sciences, Center for Health and Medical Psychology, Örebro University, Sweden
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Hårdstedt Maria
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Sweden
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- Vansbro Primary Health Care Center, Vansbro, Sweden
| | - Jansson Stefan
- School of Medical Sciences, University Health Care Research Centre, Örebro University, Örebro, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Lernmark Åke
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Sundqvist Martin
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Sweden
| | - Tevell Staffan
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Sweden
- Department of Infectious Diseases, Karlstad Hospital and Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden
| | | | - Wahlberg Jeanette
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Sweden
| | - Jendle Johan
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Sweden
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Morat B, Lucidarme N, Gibert A, Harbulot C, Lachaume N, Gréteau S, Basmaci R. Impact of lockdown on children with type-1 diabetes: returning to the community was associated with a decrease in HbA1c. Front Pediatr 2023; 11:1245861. [PMID: 38188912 PMCID: PMC10769491 DOI: 10.3389/fped.2023.1245861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Background In March 2020, a 2-month lockdown of the entire population has been declared in France to limit the spread of COVID-19. Sudden changes in daily life can impact the glycemic control of patients with type 1 diabetes (T1D), especially children and adolescents. We aimed to assess the impact of the lockdown on glycemic control in children and adolescents with T1D. Methods Children with T1D were prospectively recruited in two pediatric centers from May 11 to August 1, 2020. At inclusion, patients and/or parents were asked to fill in a form assessing the patient's lifestyle during the lockdown and a medical case report form was filled in by clinician. The mean of the three last glycated hemoglobin (HbA1c) values obtained before lockdown (HbA1c_mean; before March 17, 2020) was compared to the first HbA1c value measured after the lockdown (HbA1c_after; from May 11 to August 1, 2020). Univariable and multivariable analyses were performed, as appropriate, to identify factors associated with glycemic changes during lockdown. Results One-hundred-and-eighteen children and adolescents (median age was 14.1 years, 50% males) with T1D (median time from diagnosis was 4.1 years) were enrolled in the study. No significant difference was observed between medians of HbA1c_mean and HbA1c_after values (8.37% [7.88; 9.32%] vs. 8.50% [7.70; 9.50%], respectively; p = 0.391). Returning to the community was a protective factor [OR 0.31 (0.09-0.94); p = 0.045]. Patients having increased HbA1c were more frequently in contact with a suspected case of COVID-19 [OR 9.07 (2.15-53.66); p = 0.006], whereas patients having decreased HbA1c had the feeling of increase number of hypoglycemia [OR 0.19 (0.05-0.57); p = 0.006]. Conclusion In our patients, HbA1c before and after the lockdown was stable. In subgroup analysis, returning to the community was a protective factor. In addition, feeling of hypoglycemia was more frequent in the patients with decreased HbA1c.
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Affiliation(s)
- Benjamin Morat
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
| | - Nadine Lucidarme
- Service de Pédiatrie Générale, AP-HP, Hôpital Jean-Verdier, Bondy, France
| | - Auriane Gibert
- Service de Pédiatrie Générale, AP-HP, Hôpital Jean-Verdier, Bondy, France
| | - Carole Harbulot
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
| | - Noémie Lachaume
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
| | - Stéphanie Gréteau
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
| | - Romain Basmaci
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
- Université Paris Cité, Inserm, IAME, Paris, France
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Almutairi N, Gopaldasani V, Hosseinzadeh H. The Effect of a Patient Activation Tailored Intervention on Type 2 Diabetes Self-Management and Clinical Outcomes: A Study from Saudi Arabian Primary Care Settings. J Diabetes Res 2023; 2023:2074560. [PMID: 38059208 PMCID: PMC10696472 DOI: 10.1155/2023/2074560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/23/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is a global public health challenge. T2DM self-management, including diet, physical activity, blood glucose self-monitoring, foot care, and adherence to medication, is considered a primary tool for managing diabetes. Patient activation, an individual's knowledge, skill, and confidence in managing their health and healthcare, was recognized to be associated with better T2DM self-management and clinical outcomes. Patient activation intervention has been described as a potential approach for enhancing chronic disease self-management. This study is aimed at examining the effect of a patient activation-tailored intervention on T2DM self-management and clinical outcomes in primary care settings in Saudi Arabia. Method A pre- and postintervention study was conducted among ≥18 years old T2DM patients attending primary healthcare centers in Saudi Arabia. Collected data included demographics, clinical data, the Patient Activation Measure (PAM), the Summary of Diabetes Self-Care Activities (SDSCA), the diabetes knowledge test (DKT2), the problem area in diabetes test (PAID-5), and the diabetes quality of life test (DQOL). The intervention was tailored based on the participants' patient activation level. The intervention consisted of monthly face-to-face sessions for three months and a telephone follow-up per month for three months postintervention. Descriptive statistics, a paired sample t-test for scale variables, and Wilcoxon's signed-rank test for categorical variables were used for data analysis. Results A total of 82 patients, mostly female (61%) with a mean age of 51.3 ± 9.9 years old, completed baseline and postintervention surveys. After six months of intervention, there was a significant change in patient activation score from 54.74 to 61.58 (p < 0.001), hemoglobin A1c (HbA1c) from 8.38 to 7.55 (p < 0.001), and body mass index (BMI) from 30.90 to 29.16 (p < 0.001). Also, there was a significant change in SDSCA scores (diet from 3.12 to 3.67, exercise from 2.54 to 3.49, and blood glucose self-testing from 2.37 to 3.24) (p < 0.001) and DKT from 6.29 to 7.22 (p = 0.01). Conclusion Our findings suggested that tailoring interventions based on patients' activation levels is more likely to yield promising T2DM self-management and clinical outcomes.
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Affiliation(s)
- Nasser Almutairi
- School of Health & Society, University of Wollongong, NSW, Australia
- Public Health Sector, Ministry of Health, Riyadh, Saudi Arabia
| | - Vinod Gopaldasani
- School of Health & Society, University of Wollongong, NSW, Australia
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11
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Koonmen LA, Lennie TA, Hieronymus LB, Rayens MK, Ickes M, Miller JL, Mudd-Martin G. COVID-19 Impact Predicts Diabetes Distress Among Individuals With Type 2 Diabetes. Sci Diabetes Self Manag Care 2023; 49:392-400. [PMID: 37658648 DOI: 10.1177/26350106231196300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
PURPOSE The purpose of this study was to determine whether COVID-19 impact and Diabetes Self-Management Education and Support (DSMES) service attendance predicted diabetes distress among individuals with type 2 diabetes during the pandemic. METHODS Eighty-six adults with type 2 diabetes who either attended (n = 29) or did not previously attend (n = 57) DSMES services completed a cross-sectional survey. Participants' mean age was 57 ± 12.3 years, 50% were female, and 71.3% were diagnosed with diabetes >5 years. The Coronavirus Impact Scale was used to measure impact of the pandemic on daily life. The Diabetes Distress Scale was used to measure distress overall and within 4 subscales (emotional burden, interpersonal distress, physician-related distress, regimen distress). Separate multiple linear regressions were conducted for each outcome, controlling for age, sex, marital status, financial status, and time since diabetes diagnosis. RESULTS Higher COVID-19 impact predicted higher diabetes-related distress for all subscales and overall. Only the subscale for interpersonal distress was predicted by DSMES attendance, which decreased with DSMES attendance. CONCLUSION This study identifies a link between the effects of the COVID-19 pandemic and diabetes distress. The findings highlight the negative impact of the pandemic on diabetes distress and the importance of DSMES services for diabetes-related distress. Interventions are needed to reduce psychological distress among this population during public health crises.
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Affiliation(s)
- Leigh Anne Koonmen
- Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, Michigan
| | - Terry A Lennie
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | | | - Mary Kay Rayens
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | - Melinda Ickes
- College of Education, College of Nursing, University of Kentucky, Lexington, Kentucky
| | | | - Gia Mudd-Martin
- College of Nursing, University of Kentucky, Lexington, Kentucky
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12
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Zeiler M, Wittek T, Graf T, Bozic I, Nitsch M, Waldherr K, Karwautz A, Wagner G, Berger G. Psychosocial impact of the COVID-19 pandemic for adolescents with type-1-diabetes: a qualitative interview study involving adolescents and parents. Behav Med 2023; 49:412-422. [PMID: 35816425 DOI: 10.1080/08964289.2022.2084358] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/02/2022] [Accepted: 05/24/2022] [Indexed: 12/23/2022]
Abstract
This study aims to investigate the psychosocial impact of the COVID-19 pandemic on adolescents with type-1-diabetes (T1D). We conducted 18 semi-structured interviews including adolescents with T1D (n = 10, 50% female, 15-18 years) and their parents (n = 8, 88% mothers). The main topics addressed were experiences during confinement regarding everyday life, lifestyle behaviors, diabetes management and treatment. We applied thematic analysis to identify common patterns of meanings. Being aware of belonging to a potential COVID-19 risk group caused worries especially in parents which resulted in strict adherence to preventive measures. Information from trustworthy sources regarding the actual risk mitigated the concerns. Digital diabetes treatment was well accepted and experienced as highly usable. The pandemic situation either facilitated or hindered the transition from parental control to diabetes self-management. While some patients managed to improve healthy lifestyle behaviors as their everyday lives seemed more predictable, others had difficulties in adapting to changed daily routines resulting in increased sedentary behavior and snacking. The perceived level of stress was directly associated with blood glucose levels. In conclusion, the implementation of psychological interventions (both for adolescents with T1D and their parents) addressing mental health literacy and media literacy seems to be important to promote positive coping skills for dealing with the pandemic situation.
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Affiliation(s)
- Michael Zeiler
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna
| | - Tanja Wittek
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna
| | - Theres Graf
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna
| | - Ina Bozic
- Diabetes Unit, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna
| | - Martina Nitsch
- Ferdinand Porsche FernFH - Distance Learning University of Applied Sciences
| | - Karin Waldherr
- Ferdinand Porsche FernFH - Distance Learning University of Applied Sciences
| | - Andreas Karwautz
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna
| | - Gudrun Wagner
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna
| | - Gabriele Berger
- Diabetes Unit, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna
- Pediatric Diabetes Outpatient Clinic, Health Care Centre Vienna Floridsdorf
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Dávid A, Szántó KJ, Fábián A, Resál T, Farkas K, Hallgató E, Miheller P, Sarlós P, Molnár T, Rafael B. Psychological characteristics of patients with inflammatory bowel disease during the first wave of COVID-19. PRZEGLAD GASTROENTEROLOGICZNY 2023; 18:334-343. [PMID: 37937107 PMCID: PMC10626386 DOI: 10.5114/pg.2023.131398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 08/09/2022] [Indexed: 11/09/2023]
Abstract
Introduction Inflammatory bowel diseases (Crohn's disease (CD) and ulcerative colitis (UC)) are chronic, immune-mediated diseases with unclear aetiology, characterized by relapsing inflammation of the gastrointestinal tract. These conditions significantly impair patients' physical and mental condition and quality of life. Aim To investigate the impact of the current pandemic situation on inflammatory bowel disease (IBD) patients' psychological status and to determine factors that mediate the level of depression, anxiety, and health-related quality of life. Material and methods This was a multicentre, observational, cross-sectional, questionnaire-based study. A total of 206 participants (male: 34%) were involved. The online survey consisted of 8 different psychological measures (such as depression, anxiety, coronavirus distress, health-related quality of life, etc.) and other therapy-specific and sociodemographic factors. Results 28.2% of respondents showed depressive symptoms and 11.2% indicated moderate to severe anxiety. Also, 27.7% revealed mild, moderate, or severe distress regarding the coronavirus situation. According to regression analysis, anxiety and coronavirus distress are mostly influenced by psychological factors. In contrast, the changes in quality of life and depression can be explained by disease-specific and psychological factors as well. Conclusions Patients need more attention during this period to help them cope with psychological factors and prevent their IBD from becoming worse.
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Affiliation(s)
- Anett Dávid
- Department of Medicine, University of Szeged, Szeged, Hungary
| | | | - Anna Fábián
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Tamás Resál
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Klaudia Farkas
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Emese Hallgató
- Institute of Psychology, University of Szeged, Szeged, Hungary
| | - Pál Miheller
- 1 Department of Surgery, Semmelweis University, Budapest, Hungary
| | - Patrícia Sarlós
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Molnár
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Beatrix Rafael
- Department of Preventive Medicine, University of Szeged, Szeged, Hungary
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Yardeni M, Shaked OZ, Pienik R, Ben-Ami M, Stern E, Golan H, Waldman D, Gothelf D, Modan-Moses D. Impact of COVID-19 on Lifestyle Habits and Emotional State of Childhood Cancer Survivors and Their Parents. Nutrients 2023; 15:3932. [PMID: 37764717 PMCID: PMC10537817 DOI: 10.3390/nu15183932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/02/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic and associated social distancing measures affected the physical and emotional state of children and parents worldwide. Survivors of childhood cancer may be particularly vulnerable to these effects. We aimed to evaluate the lifestyle habits and emotional states of childhood cancer survivors and their parents during the COVID-19 outbreak. METHODS Lifestyle habits and emotional distress were assessed in 43 childhood cancer survivors (aged 8-21 years) and their parents before and during the COVID-19 lockdown, using the PROMIS anxiety and depression modules and the "Mabat Youth" questionnaire. RESULTS Most parents (80.5%) reported eating more family meals during home confinement compared to their usual routine. Patients' physical activity levels did not change significantly during confinement, leisure-related screen time nearly doubled (p < 0.001), and sleep duration increased (p = 0.006). Anxiety levels of children (p = 0.045) and parents (p = 0.02) increased during confinement compared to pre-pandemic levels, with no significant changes in depression levels. CONCLUSIONS Contrary to concerns regarding lifestyle habits during the COVID-19 lockdown, eating behaviors of childhood cancer survivors improved, sleep duration increased, and physical activity remained unchanged. Still, screen time increased significantly. Parents of childhood cancer survivors reported higher anxiety levels for themselves and their children during home confinement. Our findings may assist medical and psycho-social teams in guiding parents of cancer survivors during similar circumstances in the future.
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Affiliation(s)
- Maya Yardeni
- Division of Pediatric Hemato-Oncology, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (H.G.)
| | - Omer Zvi Shaked
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (O.Z.S.); (E.S.)
| | - Reut Pienik
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (O.Z.S.); (E.S.)
| | - Michal Ben-Ami
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (O.Z.S.); (E.S.)
| | - Eve Stern
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (O.Z.S.); (E.S.)
| | - Hana Golan
- Division of Pediatric Hemato-Oncology, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (H.G.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Dalia Waldman
- Division of Pediatric Hemato-Oncology, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (H.G.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Doron Gothelf
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
- The Child Psychiatry Division, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Dalit Modan-Moses
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 5262000, Israel; (O.Z.S.); (E.S.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
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15
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Allen LP, Ellis L, Engleton C, Valerio VL, Hatala AR. Voices of those living with type 2 diabetes in Belize: barriers to care before and during the COVID-19 pandemic. Int J Equity Health 2023; 22:163. [PMID: 37620814 PMCID: PMC10463824 DOI: 10.1186/s12939-023-01987-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/14/2023] [Indexed: 08/26/2023] Open
Abstract
Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America, and fifth direst in the world. T2D is the leading cause of death in Belize, a country facing burdens of increasing prevalence with few resources. Since March of 2020, the COVID-19 pandemic has exacerbated the difficulties of those living with T2D in Belize. To address T2D issues in Belize, our interdisciplinary research team explored the barriers to care and self-management for adult patients with T2D in Belize prior to and during the COVID-19 pandemic.Research relationships between Canadian (ARH) and Belizean (LE) authors have been ongoing since 2016. Together we used a qualitative Constructivist Grounded Theory design generating knowledge through 35 semi-structured patient interviews, 25 key informant discussions, and participant observation with field notes between February 2020 to September 2021. We used Dedoose analysis software for a systematized thematic coding process, as well as iterative verification activities. Findings revealed several barriers to care and self-management, including: 1) the tiered health and social care system with major gaps in coverage; 2) the unfulfilled demand for accurate health information and innovative dissemination methods; and 3) the compounding of loss of community supports, physical exercise, and health services due to COVID-19 restrictions. In the post-pandemic period, it is necessary to invest in physical, nutritional, economic, and psychosocial health through organized activities adaptable to changeable public health restrictions. Recommendations for activities include sending patients informational and motivational text messages, providing recipes with accessibly sourced T2D foods, televising educational workshops, making online tools more accessible, and mobilising community and peer support networks.
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Affiliation(s)
- Lindsay P Allen
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, 221 Human Ecology Bldg, Winnipeg, MB, R3T 2N2, Canada
| | - Lucia Ellis
- Belize Diabetes Association, Belize City, Belize
| | | | | | - Andrew R Hatala
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, 221 Human Ecology Bldg, Winnipeg, MB, R3T 2N2, Canada.
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16
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Mei Y, Yang X, Gui J, Li Y, Zhang X, Wang Y, Chen W, Chen M, Liu C, Zhang L. The relationship between psychological resilience and depression among the diabetes patients under the background of "dynamic zero COVID-19": the mediating role of stigma and the moderating role of medication burden. Front Public Health 2023; 11:1124570. [PMID: 37680269 PMCID: PMC10481163 DOI: 10.3389/fpubh.2023.1124570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 08/11/2023] [Indexed: 09/09/2023] Open
Abstract
Objective Depression in diabetes patients is caused by their own disease or the surrounding social environment. How to cope with changes in mentality and adjust psychological stress responses, especially under China's dynamic zero COVID-19 policy, is worth further discussion. The researchers constructed a moderated mediation model to test the effect of psychological resilience during dynamic zero COVID-19 on depression in diabetes patients and the mediating role of stigma and the moderating effect of medication burden. Method From June to September, 2022, data were collected in Jinghu District, Wuhu City, Anhui Province, by multi-stage stratified sampling. Firstly, we selected a tertiary hospital randomly in Jinghu District. Secondly, departments are randomly chosen from the hospital. Finally, we set up survey points in each department and randomly select diabetes patients. In addition, we used the Connor-Davidson Elasticity Scale (CD-RISC) to measure psychological resilience of patients, and used the Stigma Scale for Chronic Illness (SSCI) to measure stigma, medication burden was measured by the Diabetes Treatment Burden Scale (DTBQ), and depression was assessed by the Patient Health Questionnaire-9 (PHQ-9). We used SPSS (version 23.0) and PROCESS (version 4.1) for data analysis. Results (1) Psychological resilience was negatively correlated with stigma, medication burden, and depression. Stigma was positively associated with medication burden and depression. Medication burden and depression are positively correlated, (2) The mediation analysis showed that psychological resilience had a direct predictive effect on depression, and stigma partially mediated the relationship, and (3) Medication burden moderates the direct pathway by which psychological resilience predicts depression; Medication burden moderates the first half of "psychological resilience → stigma → depression." Conclusion Under the mediating effect of stigma, psychological resilience can improve depression. Medication burden has a moderating effect on the relationship between psychological resilience and depression, and it also has a moderating effect on the relationship between psychological resilience and stigma. These results facilitate the understanding of the relationship mechanisms between psychological resilience and depression.
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Affiliation(s)
- Yujin Mei
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Xue Yang
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - JiaoFeng Gui
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - YuQing Li
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - XiaoYun Zhang
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Ying Wang
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Wenyue Chen
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Mingjia Chen
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Changjun Liu
- School of Marxism, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
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17
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Sim B, Kim S, Nam EW. Evaluating the effect of the COVID-19 pandemic on hypertension and diabetes care in South Korea: an interrupted time series analysis. BMC Public Health 2023; 23:1538. [PMID: 37568089 PMCID: PMC10422749 DOI: 10.1186/s12889-023-16430-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Access to healthcare services is important, especially for patients with chronic diseases. We evaluated the effect of the COVID-19 pandemic on outpatient visits and medication for patients with hypertension and diabetes in South Korea. METHODS Nationwide claims data were extracted for patients with hypertension and diabetes from January 2019 to July 2020. We used an interrupted time series (ITS) analysis to evaluate the pandemic's impact on outpatient care using the number of outpatient visits and days of medication supplied per visit. We identified the change in the continuity of care in medication, a consequence of the change in outpatient care, using the Medication Possession Ratio (MPR). RESULTS The number of outpatient visits for diabetes significantly declined in February 2020, when community transmission began. However, when high-intensity social distancing was relaxed in April 2020, outpatient visits for hypertension and diabetes rebounded significantly. Moreover, when the outpatient visits declined, the number of days of medication supplied per visit increased. Consequently, the average MPRs significantly increased compared to 2019, increasing the ratio of patients with appropriate medication supply (MPR ≥ 0.8). CONCLUSIONS Outpatient visits decreased immediately when COVID-19 spread to local communities. However, the number of days of medication supplied per visit increased to compensate for the longer intervals between visits. Rather, the change in the continuity of care in medication improved; thus, the temporary decrease in outpatient visits might have had a limited negative impact on health outcomes.
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Affiliation(s)
- Boram Sim
- HIRA Research Institute, Health Insurance Review and Assessment Service (HIRA), Wonju, Korea
| | - Sunmi Kim
- Korea Pharmaceutical Information Service, Health Insurance Review and Assessment Service (HIRA), Wonju, Korea
| | - Eun Woo Nam
- Department of Health Administration, College of Software and Digital Convergence, Yonsei University, Wonju, Korea.
- Yonsei Global Health Center, Yonsei University, Wonju, Korea.
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Tang TS, Vesco AT, Fraser EG. Disruptions in Lifestyle Habits and Access to Social Support in the Time of COVID-19: Associations With Diabetes Distress and Depression Among Adults With Type 1 Diabetes Living in British Columbia. Can J Diabetes 2023; 47:497-502. [PMID: 37116655 PMCID: PMC10132832 DOI: 10.1016/j.jcjd.2023.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/30/2023] [Accepted: 04/21/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVES In this study, we examined rates of diabetes distress and depressive symptoms in adults with type 1 diabetes (T1D) during the COVID-19 lockdown and its association with disruptions in lifestyle habits and access to social support. METHODS This cross-sectional investigation included a convenience sample of 60 adults with T1D who completed a survey assessing diabetes distress (Type 1 Diabetes Distress Scale), depressive symptoms (Personal Health Questionnaire-9), and disruptions in lifestyle habits (sleep patterns, dietary patterns, exercise routine) and access to support from family/friends. Linear regression analyses examined COVID-19 disruption variables as predictors of diabetes distress and depressive severity. RESULTS Seventy-three percent and 38% of participants reported elevated diabetes distress and depressive symptoms, respectively. Greater eating disruption predicted higher depressive symptom severity (β=1.33, p=0.045) and eating distress (β=0.28, p=0.045). Greater social support disruption predicted higher eating distress (β=0.36, p=0.019). CONCLUSIONS Findings revealed high rates of diabetes distress and depressive symptoms in this T1D sample during the COVID-19 lockdown. Moreover, disruptions in some lifestyle habits and access to social support were associated with worse mental health outcomes.
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Affiliation(s)
- Tricia S Tang
- Faculty of Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Anthony T Vesco
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, United States; Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Ellen G Fraser
- The Canadian Centre for Behavioural Neuroscience, Department of Neuroscience, University of Lethbridge, Lethbridge, Alberta, Canada
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19
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Doosti-Irani M, Noorian K, Rafiee Vardanjani L, Fanti P, Odoi EW, Abdoli S. Psychosocial comorbidities of diabetes during the COVID-19 pandemic in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:210. [PMID: 37545992 PMCID: PMC10402822 DOI: 10.4103/jehp.jehp_892_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/25/2022] [Indexed: 08/08/2023]
Abstract
BACKGROUND The psychosocial impacts of the COVID-19 pandemic are mainly focused on the general population, while pandemics do not impact the mental health of the entire population uniformly, especially vulnerable populations with underlying health conditions. This study aimed to investigate diabetes psychosocial comorbidities among Iranians with type 1 diabetes (T1D) during the COVID-19 pandemic. This study aimed to investigate diabetes psychosocial comorbidities among Iranians with type 1 diabetes (T1D) during the COVID-19 pandemic. MATERIALS AND METHODS This was a cross-sectional study of 212 adults with T1D in different cities in Iran. Study participants completed an online survey in April-June 2020. The survey collected self-reported data on diabetes psychosocial comorbidities (i.e. diabetes burnout, diabetes distress, and depressive symptoms). Demographic and COVID-19 data before and during the pandemic were also collected. Responses were analyzed using ordinary least squares and logistic regression methods. RESULTS Around 17.5% reported being tested for COVID-19 virus, 8% were diagnosed positive, 10.8% were hospitalized, and 92.9% followed precaution recommendations during the pandemic. Participants had high levels of diabetes distress (57.1%), depressive symptoms (60.8%), and diabetes burnout (mean score = 3.1 out of 5). During the pandemic, trouble paying for the very basic needs was a consistent factor increasing the risk of diabetes distress, diabetes burnout, and depressive symptoms. Lack of access to diabetes care was only associated with diabetes burnout, while diabetes hospitalization/emergency department (ED) visit was associated with diabetes distress. Existing diabetes disparities before the pandemic were also associated with higher scores of diabetes psychosocial comorbidities [accessing diabetes supplies and medications (P < 0.0001) and places for physical exercise (P < 0.0333)]. CONCLUSION The negative impact of the COVID-19-related changes on individuals with diabetes, as one of the most vulnerable populations, must be recognized alongside the physical, financial, and societal impact on all those affected. Psychological interventions should be implemented urgently in Iran, especially for those with such characteristics.
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Affiliation(s)
- Mehri Doosti-Irani
- School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Iran
| | - Kobra Noorian
- School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Iran
| | - Leila Rafiee Vardanjani
- School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Iran
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Paulo Fanti
- Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil. Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas-SP, Brasil, Brazil
| | - Evah W. Odoi
- Department of Public Health, The University of Tennessee, 1914 Andy Holt Avenue, Knoxville, TN, USA
| | - Samereh Abdoli
- College of Nursing, University of Tennessee, 1200 Volunteer Blvd Rm 155, Knoxville, TN, USA
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Khodabakhsh P, Asadnia A, Moghaddam AS, Khademi M, Shakiba M, Maher A, Salehian E. Prediction of in-hospital mortality rate in COVID-19 patients with diabetes mellitus using machine learning methods. J Diabetes Metab Disord 2023; 22:1-14. [PMID: 37363202 PMCID: PMC10182753 DOI: 10.1007/s40200-023-01228-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 04/24/2023] [Indexed: 06/28/2023]
Abstract
Background Since its emergence in December 2019, until June 2022, coronavirus 2019 (COVID-19) has impacted populations all around the globe with it having been contracted by ~ 535 M people and leaving ~ 6.31 M dead. This makes identifying and predicating COVID-19 an important healthcare priority. Method and Material The dataset used in this study was obtained from Shahid Beheshti University of Medical Sciences in Tehran, and includes the information of 29,817 COVID-19 patients who were hospitalized between October 8, 2019 and March 8, 2021. As diabetes has been shown to be a significant factor for poor outcome, we have focused on COVID-19 patients with diabetes, leaving us with 2824 records. Results The data has been analyzed using a decision tree algorithm and several association rules were mined. Said decision tree was also used in order to predict the release status of patients. We have used accuracy (87.07%), sensitivity (88%), and specificity (80%) as assessment metrics for our model. Conclusion Initially, this study provided information about the percentages of admitted Covid-19 patients with various underlying disease. It was observed that diabetic patients were the largest population at risk. As such, based on the rules derived from our dataset, we found that age category (51-80), CPR and ICU residency play a pivotal role in the discharge status of diabetic inpatients.
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Affiliation(s)
- Pooneh Khodabakhsh
- Department of IT and Computer Engineering, Azad Islamic University South Tehran Branch, Tehran, Iran
| | - Ali Asadnia
- Institute of Social Sciences, Department of Business Analytics, Marmara University, Istanbul, Turkey
| | | | - Maryam Khademi
- Department of Applied Mathematics, Azad Islamic University South Tehran Branch, Tehran, Iran
| | - Majid Shakiba
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Maher
- Department of Health Policy, Economics and Management, School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Salehian
- Department of Information Technology, Medical Science of Shahid, Beheshti University, Tehran, Iran
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Troncone A, Cascella C, Chianese A, Zanfardino A, Pizzini B, Iafusco D. Psychological consequences of the COVID-19 pandemic in people with type 1 diabetes: A systematic literature review. J Psychosom Res 2023; 168:111206. [PMID: 36913765 PMCID: PMC9972771 DOI: 10.1016/j.jpsychores.2023.111206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/13/2023] [Accepted: 02/25/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE A comprehensive picture of the data on the impact of COVID-19 on the mental health of individuals with type 1 diabetes (T1D) is currently lacking. The purpose of this systematic review was to synthesize extant literature reporting on the effects of COVID-19 on psychological outcomes in individuals with T1D and to identify associated factors. METHODS A systematic search was conducted with PubMed, Scopus, PychInfo, PsycArticles, ProQuest, and WoS using a selection procedure according to the PRISMA methodology. Study quality was assessed using a modified Newcastle-Ottawa Scale. In all, 44 studies fulfilling the eligibility criteria were included. RESULTS Findings suggest that during the COVID-19 pandemic, people with T1D had impaired mental health, with relatively high rates of symptoms of depression (11.5-60.7%, n = 13 studies), anxiety (7-27.5%, n = 16 studies), and distress (14-86.6%, n = 21 studies). Factors associated with psychological problems include female gender, lower income, poorer diabetes control, difficulties in diabetes self-care behaviors, and complications. Of the 44 studies, 22 were of low methodological quality. CONCLUSIONS Taking appropriate measures to improve medical and psychological services is needed to support individuals with T1D in appropriately coping with the burden and difficulties caused by the COVID-19 pandemic and to prevent mental health problems from enduring, worsening, or having a long-term impact on physical health outcomes. Heterogeneity in measurement methods, lack of longitudinal data, the fact that most included studies did not aim to make a specific diagnosis of mental disorders limit the generalizability of the findings and have implications for practice.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "Luigi Vanvitelli", 81100, Viale Ellittico 31, Caserta, Italy
| | - Crescenzo Cascella
- Department of Psychology, University of Campania "Luigi Vanvitelli", 81100, Viale Ellittico 31, Caserta, Italy
| | - Antonietta Chianese
- Department of Psychology, University of Campania "Luigi Vanvitelli", 81100, Viale Ellittico 31, Caserta, Italy
| | - Angela Zanfardino
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138 Naples, Italy.
| | - Barbara Pizzini
- Department of Psychology, University of Campania "Luigi Vanvitelli", 81100, Viale Ellittico 31, Caserta, Italy
| | - Dario Iafusco
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138 Naples, Italy
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Sartore G, Caprino R, Ragazzi E, Lapolla A. Telemedicine and its acceptance by patients with type 2 diabetes mellitus at a single care center during the COVID-19 emergency: A cross-sectional observational study. PLoS One 2023; 18:e0269350. [PMID: 36791131 PMCID: PMC9931089 DOI: 10.1371/journal.pone.0269350] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION When Italy was placed under lockdown to contain the COVID-19 pandemic from 9 March to 18 May 2020, alternative approaches to delivering care-such as telemedicine-were promoted for patients with chronic diseases like diabetes mellitus (DM). The aim of this study was to analyze patients' perception of, and satisfaction with the telehealth services offered during the COVID-19 emergency at an outpatient diabetes care unit in Italy. METHODS A cross-sectional survey was conducted on 250 patients with type 2 diabetes mellitus who regularly attended our diabetes care unit. Data were collected by means of telephone interviews, asking patients how they perceived the telehealth services, and their satisfaction with the televisit and computer-based care. A standardized questionnaire was administered: there were questions answered using a five-point Likert scale, and one open-ended question. Patients' demographic, anthropometric and biological data were collected from their medical records. Correlations between patients' characteristics, their perception of telemedicine, and their satisfaction with the televisit were examined. Spearman's rank-order correlation coefficient ρ (rho) and Kendall's rank correlation coefficient τ (tau) were used as nonparametric measures of the strength of the association between the scores obtained for the two ordinal variables, Perception and Satisfaction, and between other clinical parameters. Principal component analysis (PCA) was also used to assess overall links between the variables. RESULTS Almost half of the interviewees expressed a strongly positive perception of the medical services received, and more than 60% were very satisfied with the telehealth service provided during the COVID-19 emergency. There was a strong correlation between patients' perception and satisfaction ratings (p<0.0001). Duration of disease showed a significant positive correlation with patients' satisfaction with their medical care. By means of PCA, it was found that BMI correlated inversely with both perception and satisfaction. Following a qualitative analysis of patients' answers to the open-ended question, contact with their specialist was important to them: it was reassuring and a source of scientifically correct information about their disease and the association between COVID-19 and diabetes. CONCLUSIONS Based on our telephone interviews, patients appreciated the telehealth approach and were satisfied with it, regardless of the characteristics of their disease. Telemedicine proved essential to avoid interrupting the continuity of care, and therefore had not only clinical, but also psycho-social repercussions.
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Affiliation(s)
| | - Rosaria Caprino
- Department of Medicine–DIMED, University of Padua, Padua, Italy,* E-mail:
| | - Eugenio Ragazzi
- Department of Pharmaceutical and Pharmacological Sciences–DSF, University of Padua, Padua, Italy
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Pettersson S, Jaarsma T, Hedgärd K, Klompstra L. Self-care in migrants with type 2 diabetes, during the COVID-19 pandemic. J Nurs Scholarsh 2023; 55:167-177. [PMID: 36353793 PMCID: PMC10098933 DOI: 10.1111/jnu.12842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Type 2 diabetes is increasing globally and particularly affects vulnerable groups in society, such as migrants. Research shows that type 2 diabetes is a risk factor for severe illness when infected with COVID-19. Diabetes-related complications can be prevented with good glycaemic control. In addition, good glycaemic control has been shown to be an important cornerstone for preventing severe illness in individuals infected with COVID-19. In order to maintain good glycaemic control, self-care is needed. The purpose of this article is to describe self-care maintenance and possible changes in self-care maintenance and to explore factors related to unchanged self-care maintenance in migrant patients with type 2 diabetes during the COVID-19 pandemic. The second aim is to describe well-being, social support, and the need for support from healthcare services during the COVID-19 pandemic in migrant patients with type 2 diabetes. DESIGN/METHOD A triangulation design with cross-sectional data collection was used. Both quantitative and qualitative data were collected and interpreted together in a triangulation design. Patients were selected by a diabetes nurse from a computer system at a health center in south-eastern Sweden and invited to participate in the study. A questionnaire was translated into the languages most commonly used at the clinic and sent out to 332 migrant patients who had been diagnosed with type 2 diabetes and treated in primary care. This questionnaire assessed self-care maintenance for diabetes (questions inspired by the Self-Care of Diabetes Inventory), with questions added to every item to assess changes during the pandemic. When changes occurred, we asked the participants to elaborate. Open-ended questions asked the participants how they would like to receive information when there are changes in their healthcare. Descriptive statistical analyses were used for the quantitative data and qualitative data was analyzed using a directed approach to content analysis. RESULTS In total, 79 participants answered the questionnaire (mean age 69 ± 11, 51% male, 47% born in the Middle East). Of these, 76% stated a change in self-care. More than half (58%) stated changes in maintaining an active lifestyle, 40% had changed their physical exercise, and 38% had changed their behavior to avoid getting sick. Participants said that this change was due to staying at home or canceling social activities because they feared meeting people during the pandemic. Others were more physically active than before on a regular basis during the pandemic due to taking walks to get fit, as a precaution related to COVID-19, and having greater awareness about how to avoid getting sick. Approximately one-quarter of the participants experienced a change in contact with healthcare due to poorer access to care, with fewer doctors' appointments and care being postponed during the pandemic. More than half (58%) would like to receive information about healthcare changes by a letter in the regular mail. Social support had changed for 35% of the participants, with less support from family and friends due to the risk of being infected with COVID-19. CONCLUSION The COVID-19 pandemic led to societal restrictions that changed the way of life for many individuals. Migrant patients with type 2 diabetes, who are already a vulnerable group regarding self-care, had difficulties in maintaining good living habits during the pandemic. During crises such as COVID-19, support with self-care, such as closer contact with healthcare providers, is vital. CLINICAL RELEVANCE Knowledge about how the COVID-19 pandemic has affected migrants with type 2 diabetes can be used to support healthcare providers in identifying individuals who are at high risk of suffering from the consequences of their diabetes associated with the pandemic.
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Affiliation(s)
- Sara Pettersson
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Klara Hedgärd
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
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Rumrill PD, Lee B, Minton D, Bishop ML, Koch LC, Pittman C. Emerging vocational rehabilitation strategies for people with diabetes mellitus. Work 2022; 73:753-759. [DOI: 10.3233/wor-223648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND: People with diabetes mellitus constitute an emerging vocational rehabilitation (VR) consumer population. OBJECTIVE: The objective of this article is to (a) describe the characteristics and needs of Americans with diabetes mellitus, (b) examine the often devastating effects that this highly prevalent disease of the endocrine system has on employment and career development, and (c) suggest strategies that rehabilitation professionals can use to improve VR services and outcomes. METHOD: Following an overview of the etiology, incidence, prevalence, and impact of this high incidence endocrinological disease, the authors present strategies to meet the service and support needs of Americans with diabetes mellitus across the phases of the VR process. RESULTS: The importance of individualized case planning, employer consultation, workplace accommodations, interface with medical and mental health professionals, and adherence to self-care and symptom management regimens is emphasized throughout the article. CONCLUSION: Diabetes mellitus is an emerging disability that can affect people of any age, one that disproportionally affects people of color and people who live in poverty. Rehabilitation professionals must be prepared to meet the service needs of this growing clientele.
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Affiliation(s)
| | - Beatrice Lee
- Michigan State University, East Lansing, MI, USA
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Lavikainen P, Lamidi ML, Repo T, Inglin L, Martikainen J, Laatikainen T. Effects of COVID-19 Pandemic and Lockdown on Monitoring and Treatment Balance of Finnish Coronary Heart Disease and Type 2 Diabetes Patients. Clin Epidemiol 2022; 14:1363-1373. [PMID: 36387927 PMCID: PMC9664920 DOI: 10.2147/clep.s387461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/27/2022] [Indexed: 02/17/2024] Open
Abstract
PURPOSE We aimed to examine the effect of the COVID-19 pandemic and lockdown on monitoring and treatment balance of Finnish coronary heart disease (CHD) and type 2 diabetes (T2D) patients. PATIENTS AND METHODS We used data from the electronic health records on 1604 CHD and 10,136 T2D patients aged 18‒85 years in Eastern Finland. Measurement and levels of low-density lipoprotein cholesterol (LDL) of CHD patients and glycated haemoglobin (HbA1c) of T2D patients were assessed monthly during January 2019-June 2021. Interrupted time-series analysis design was utilized to examine the effect of the lockdown on proportion of patients monitored and treatment balance. RESULTS Reductions in frequencies of LDL testing of CHD and HbA1c testing of T2D patients were observed during the national lockdown. Downward trend in average LDL was observed from January 2019 until June 2021. Average HbA1c values increased from January 2019 to March 2020 with an additional increase by 2.04 mmol/mol (0.80 to 3.29) in April 2020. However, there was a downward trend in monthly average HbA1c during the lockdown until June 2021 with an additional change in level by 0.61 mmol/mol (95% CI 0.06 to 1.16) in July 2020. CONCLUSION The lockdown decreased the frequency of monitoring among both CHD and T2D patients. Meanwhile, monthly average LDL had a steadily improving pattern in CHD patients during the follow-up while temporary worsening in HbA1c in patients with T2D was observed at the time of the lockdown. The lockdown may have introduced selection in patients who had their treatment outcomes monitored. Better self-management of risk factors among patients is also possible.
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Affiliation(s)
- Piia Lavikainen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Marja-Leena Lamidi
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Teppo Repo
- Department of Geographical and Historical Studies, University of Eastern Finland, Joensuu, Finland
| | - Laura Inglin
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | - Tiina Laatikainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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BAŞKAYA E, KAYA Ç. Bireylerin Aşılara Yönelik Tutumları Üzerine COVID-19 Korkusunun Etkisi. DOKUZ EYLÜL ÜNIVERSITESI HEMŞIRELIK FAKÜLTESI ELEKTRONIK DERGISI 2022. [DOI: 10.46483/deuhfed.1013479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Giriş: Covid-19 hastalığının psikolojik etkileri devam etmektedir. Hastalığa ilişkin yaşanılan korku bireylerin Covid-19 aşılarına yönelik tutumlarını etkilemektedir.
Amaç: Bireylerin Covid-19 aşısına yönelik tutumları üzerine Covid-19 korkusunun etkisini belirlemektir.
Yöntem: Niceliksel araştırma yöntemlerinden tanımlayıcı tipte bir araştırmadır. Çalışmanın verileri 1 Temmuz- 31 Ağustos 2021 tarihleri arasında kartopu örnekleme tekniği kullanılarak online olarak toplanmıştır. Belirtilen süre içerisinde araştırmaya gönüllü olarak katılmayı kabul eden ve formu eksiksiz dolduran 221 kişi araştırmanın örneklemini oluşturmuştur. Veri toplama araçları “Katılımcı Bilgi Formu”, “Covid-19 Korku Ölçeği” ve “Covid-19 Aşısına Yönelik Tutumlar Ölçeği” dir.
Bulgular: Araştırmaya katılan bireylerin Covid-19 korku ölçeği puan ortalaması 17.84 ± 6.65; Covid-19 aşısına yönelik olumlu tutum alt boyut puan ortalaması 3.79 ± 1.12; Covid-19 aşısına yönelik olumsuz tutum alt boyut puan ortalaması 3.57 ± 1.23 olarak tespit edilmiştir. Covid-19 korku ve Covid-19 aşısına yönelik olumlu tutum değişkenleri arasında pozitif yönde, anlamlı (r = .28; p = .000) bir ilişki saptanmıştır. Ayrıca, Covid-19 korkusunun bireylerin Covid-19 aşına yönelik olumlu tutum düzeyi üzerinde anlamlı bir etkiye sahip olduğu görülmüştür (t = 4.396; p = .000).
Sonuç: Covid-19 korkusu bireylerin Covid-19 aşısına yönelik tutumunu olumlu şekilde etkilemiştir
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Menekli T, Yaprak B, Türeyen A, Şentürk S. Investigation of COVID-19 fear, treatment compliance, and metabolic control of patients with type 2 diabetes mellitus during the pandemic. Prim Care Diabetes 2022; 16:658-663. [PMID: 36030171 PMCID: PMC9376335 DOI: 10.1016/j.pcd.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/04/2022] [Accepted: 08/11/2022] [Indexed: 01/08/2023]
Abstract
AIMS This study was carried out to investigate fear levels, treatment compliance, and metabolic control of type II Diabetes Mellitus patients during the COVID-19 pandemic. METHODS The study employed a single-center, observational design and was conducted between January and April 2021. The study consisted of 303 patients who attended the internal medicine outpatient clinic of a university hospital in Turkey. For data collection, the Patient Identification Form, COVID-19 Fear Scale, and the Type II Diabetes Treatment Compliance Scale were used. The study complied with the Helsinki Declaration criteria. IBM SPSS v25.0 statistics package program was used for data analysis. RESULTS The mean age of the patients was 45.8 ± 7.5 years, the mean duration of illness was 8.2 ± 3.6 years. Moreover, 40.6% of patients presented with poor levels of treatment compliance. In addition, the mean FCV-19S score of the patients was 29.1 ± 3.05. It was noticeable that those with high mean scores of FCV-19S had poor compliance with treatment and metabolic control during the pandemic (p < 0.05). PRACTICE IMPLICATIONS Fear of COVID-19 negatively affects treatment compliance and metabolic control of type II diabetes patients. The patients avoided attending their regular follow-ups at the hospital due to fear of contracting COVID-19. In order to reduce the fear of COVID-19 it is paramount to maintain optimum metabolic control and treatment compliance.
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Affiliation(s)
- Tuğba Menekli
- Department of Internal Medicine Nursing, Malatya Turgut Özal University, Faculty of Health Sciences, Battalgazi, Malatya, Turkey.
| | - Bülent Yaprak
- Department of Internal Medicine, Malatya Turgut Özal University, Faculty of Medicine, Battalgazi, Malatya, Turkey.
| | - Aynur Türeyen
- Department of Internal Medicine Nursing, Faculty of Nursing, Ege University, Bornova, İzmir, Turkey.
| | - Sibel Şentürk
- Department of Internal Medicine Nursing, Burdur Mehmet Akif Ersoy University, Bucak Health School, Bucak, Burdur, Turkey.
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Mónaco E, Schoeps K, Valero-Moreno S, Castro-Calvo J, Montoya-Castilla I, Del Rosario C, Coello F, Herrera S, Trujillo Á, Munevar FR, Esparza NAA. Cross-cultural validation of the Worries about COVID-19 and its consequences Scale (W-COV) in adolescents and young people. Arch Psychiatr Nurs 2022; 40:158-166. [PMID: 36064240 PMCID: PMC9278999 DOI: 10.1016/j.apnu.2022.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/28/2022] [Accepted: 07/09/2022] [Indexed: 12/15/2022]
Abstract
The pandemic context presents remarkable psychological challenges for adolescents and young adults. The aim of the present work was to construct and study the psychometric properties of a scale in Spanish language (W-COV) to measure their worries related to the pandemic. Participants were 5559 people aged between 14 and 25 years old (M = 19.05; SD = 3.28). Self-report data were collected using a cross-sectional and cross-cultural design. Participants were from 5 Spanish-speaking countries. Instruments were W-COV to assess worries about COVID-19 and its consequences; DASS-21 for anxiety, depression and stress; and SWLS for life satisfaction. Exploratory, confirmatory and multi-group factor analyses were conducted to determine the factorial structure of the W-COV and its measurement invariance (configural, metric, scalar and error variance). Correlational and regression analyses were also performed to study convergent and predictive validity. The results suggest that W-COV presents a bifactorial structure: (1) a general factor of worries about COVID-19; and (2) three different factors: worries about health, economic and psychosocial consequences from COVID-19. The internal reliability indices Cronbach's α and Omega were adequate. With respect to the invariance results, the instrument can be used interchangeably in the five countries considered, in both genders and in two different age groups (12-17 and 18-25). Regarding validity, W-COV factors were positively associated with anxiety, depression and stress, and negatively predicted life satisfaction. In conclusion, W-COV is a reliable and valid instrument for researchers and health care professionals to assess the psychological impact of the pandemic on mental health of young Ibero-Americans.
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Affiliation(s)
- Estefanía Mónaco
- Department of Personality, Assessment and Psychological Treatments, Universitat de València (Valencia, Spain)
| | - Konstanze Schoeps
- Department of Personality, Assessment and Psychological Treatments, Universitat de València (Valencia, Spain)
| | - Selene Valero-Moreno
- Department of Developmental and Educational Psychology, Universitat de València (Valencia, Spain)
| | - Jesús Castro-Calvo
- Department of Personality, Assessment and Psychological Treatments, Universitat de València (Valencia, Spain)
| | - Inmaculada Montoya-Castilla
- Department of Personality, Assessment and Psychological Treatments, Universitat de València (Valencia, Spain).
| | | | - Fernanda Coello
- Department of Clinical Psychology, Universidad de Azuay (Cuenca, Ecuador)
| | - Sebastián Herrera
- Department of Clinical Psychology, Universidad de Azuay (Cuenca, Ecuador)
| | - Ángela Trujillo
- Department of Psychology, Universidad de la Sabana (Chía, Colombia)
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Tapager I, Joensen LE, Vrangbæk K. The role of self-efficacy, well-being capability and diabetes care assessment for emotional and diabetes management challenges during the COVID-19 pandemic: Findings from a follow-up study. Soc Sci Med 2022; 310:115276. [PMID: 36063674 PMCID: PMC9395231 DOI: 10.1016/j.socscimed.2022.115276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/26/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Ina Tapager
- Department of Public Health, University of Copenhagen, Denmark.
| | | | - Karsten Vrangbæk
- Department of Public Health, University of Copenhagen, Denmark; Department of Political Science, University of Copenhagen, Denmark
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Neo EYL, Sharma H, Mason L, Liu A, Poulton A, Bhurawala H. The psychosocial impact of type 1 diabetes mellitus in children and adolescents during the COVID-19 pandemic. J Paediatr Child Health 2022; 58:1786-1791. [PMID: 35770822 PMCID: PMC9796503 DOI: 10.1111/jpc.16101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/17/2022] [Accepted: 06/15/2022] [Indexed: 01/01/2023]
Abstract
AIM Type 1 diabetes mellitus has a large psychosocial impact on children and their families. This study's primary aim was to investigate whether the COVID-19 pandemic affects the psychosocial impact of T1DM and glycaemic control. METHODS During the 2020 lockdown, New South Wales residents were not allowed to leave home except for essential activities. After 3 months, children with T1DM and their parents were invited to complete online questionnaires. Data on glycaemic control were extracted from the children's clinical records with informed consent. Descriptive and comparative statistics were used to analyse the responses. RESULTS Out of 149 families, 99 responses were received, with 92 participants identified. Comparable proportions of parents (56%) and children (45%) were anxious about the child's increased risk of contracting severe illness due to COVID-19. Most responses from parents and children were closely correlated (r > 0.5, P ≤ 0.001) There was no consistent effect of lockdown on HbA1c levels, but there was a significant inverse correlation between HbA1c levels and parents' perception of the child having clear and concrete goals for diabetes care (r = -0.25, P < 0.05). The HbA1c also correlated positively with the child feeling depressed and alone with their diabetes when isolated (r = 0.36, P = 0.02). CONCLUSIONS Despite life-style changes and a negative psychosocial impact, we did not find objective evidence of any detrimental impact of the lockdown on diabetic control. However, higher HbA1c correlated with children feeling more depressed and alone. There was a comparable frequency of anxiety concerning the risk of severe COVID illness in children and their parents.
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Affiliation(s)
- Elise YL Neo
- Department of PaediatricsNepean HospitalKingswoodNew South WalesAustralia
| | - Hemani Sharma
- Department of PaediatricsNepean HospitalKingswoodNew South WalesAustralia
| | - Lynne Mason
- Child Adolescent Development UnitBlue Mountains ANZAC Memorial hospitalKatoombaNew South WalesAustralia
| | - Anthony Liu
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Alison Poulton
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Habib Bhurawala
- Department of PaediatricsNepean HospitalKingswoodNew South WalesAustralia,Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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Anxiety, Distress and Stress among Patients with Diabetes during COVID-19 Pandemic: A Systematic Review and Meta-Analysis. J Pers Med 2022; 12:jpm12091412. [PMID: 36143195 PMCID: PMC9506161 DOI: 10.3390/jpm12091412] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/20/2022] Open
Abstract
The prevalence of mental health disorders has increased during the COVID-19 pandemic. Patients with chronic diseases, such as diabetes, are a particularly vulnerable risk group. This study aims to assess the levels and prevalence of anxiety, distress, and stress in patients with diabetes during the COVID-19 pandemic. A systematic review was conducted in CINAHL, Cochrane, LILACS, Medline, SciELO, and Scopus in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Thirty-seven articles with a total of 13,932 diabetic patients were included. Five meta-analyses were performed. The prevalence of anxiety was 23% (95% CI = 19–28) in T1DM and 20% (95% CI = 6–40) in T2DM patients. For diabetes distress it was 41% (95% CI = 24–60) for T1DM and 36% in T2DM patients (95% CI = 2–84). For stress, the prevalence was 79% (95% CI = 49–98) in T1DM patients. People with diabetes have significant psychiatric comorbidity as well as psychological factors that negatively affect disease management, increasing their vulnerability in an emergency situation. To establish comprehensive care in diabetic patients addressing mental health is essential, as well as including specific policy interventions to reduce the potential psychological harm of the COVID-19 pandemic.
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Olesen K, Joensen LE, Madsen KP, Willaing I. How has the COVID-19 Pandemic Affected Diabetes Self-Management in People With Diabetes? - A One-Year Follow-Up Study. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:867025. [PMID: 36992738 PMCID: PMC10012120 DOI: 10.3389/fcdhc.2022.867025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/10/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND AND AIM In Denmark, the COVID-19 pandemic resulted in two lockdowns, one from March to May 2020 and another from December 2020 to April 2021, which had severe impact on everyday life. The aim of this study was to explore changes in diabetes self-management behaviors during the pandemic and to examine how specific population characteristics were associated with changes in diabetes management. METHODS AND PARTICIPANTS In a cohort study from March 2020 to April 2021, two online questionnaires were collected from a total of 760 people with diabetes. Descriptive statistics were used to assess the proportion of participants experiencing improvements, deterioration, and status quo in diabetes self-management during the pandemic. Using logistic regressions, baseline characteristics were explored as potential predictors of change. RESULTS Approximately half of the participants reported that they experienced lower physical activity in April 2021 compared to before the pandemic, approximately one fifth reported diabetes self-management to be more difficult than prior to the pandemic, and one fifth reported eating more unhealthily than before the pandemic. Some participants reported higher frequency of high blood glucose levels (28%), low blood glucose levels (13%) and more frequent blood glucose variability (33%) compared to before. Easier diabetes self-management was reported by relatively few participants, however, 15% reported eating more healthily, and 20% reported being more physically active. We were largely unable to identify predictors of change in exercise activities. The few baseline characteristics identified as predictors of difficulties in diabetes self-management and adverse blood glucose levels due to the pandemic were sub-optimal psychological health, including high diabetes distress levels. CONCLUSION Findings indicate that many people with diabetes changed diabetes self-management behaviors during the pandemic, mostly in a negative direction. Particularly high diabetes distress levels in the beginning of the pandemic was a predictor of both positive and negative change in diabetes self-management, indicating that people with high diabetes distress levels could potentially benefit from increased support in diabetes care during a period of crisis.
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Affiliation(s)
- Kasper Olesen
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Lene Eide Joensen
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Kristoffer Panduro Madsen
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Ingrid Willaing
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
- Section of Health Services Research, Department of Public Health, Copenhagen University, Copenhagen, Denmark
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Miller AL, Albright D, Bauer KW, Riley HO, Hilliard ME, Sturza J, Kaciroti N, Lo SL, Clark KM, Lee JM, Fredericks EM. Self-Regulation as a Protective Factor for Diabetes Distress and Adherence in Youth with Type 1 Diabetes During the COVID-19 Pandemic. J Pediatr Psychol 2022; 47:873-882. [PMID: 35609567 PMCID: PMC9213854 DOI: 10.1093/jpepsy/jsac045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic increased economic, social, and health stressors for families, yet its impacts on families of youth with chronic conditions, such as type 1 diabetes (T1D), are not well understood. Self-regulation (SR)-or the capacities to control emotions, cognition, and behavior in response to challenge-is known to support T1D management and coping in the face of stress. Strong SR may have protected youth with T1D from the impacts of pandemic-related stressors. This study compared youth and parent emotional functioning and T1D management before and after the pandemic's onset in relation to family pandemic-related stress and youth SR. METHODS Parents of youth with T1D (N = 88) and a subset of these youth (N = 43; Mean age 15.3 years [SD 2.2]) completed surveys regarding SR, stress, emotional functioning, and T1D-related functioning prior to and after March 2020. Outcomes were compared using mixed effects models adjusting for covariates. Family pandemic-related stress experiences and youth SR were tested as moderators of change. RESULTS Parents' responsibility for T1D management increased across pandemic onset and their diabetes-related distress decreased. Family pandemic-related stress was associated with decreased emotional functioning over time. Youth SR, particularly emotional and behavioral aspects, predicted better emotional and T1D-related functioning. DISCUSSION While youth with T1D whose families experienced higher pandemic-related stress had poorer adjustment, strong emotional and behavioral SR appeared to protect against worsening youth mood and adherence across pandemic onset. Both social-contextual and individual factors are important to consider when working with families managing T1D.
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Affiliation(s)
- Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Dana Albright
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Hurley O Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Julie Sturza
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Sharon L Lo
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Katy M Clark
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Joyce M Lee
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Pediatrics, Susan B. Meister Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, MI, USA
| | - Emily M Fredericks
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Pediatrics, Susan B. Meister Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, MI, USA
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Subrata SA. Holistic care of patients with diabetic foot ulcers during the COVID-19 era: integration of Henderson's Need Theory. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S38-S49. [PMID: 35980928 DOI: 10.12968/bjon.2022.31.15.s38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has inhibited the practice of diabetic foot ulcer care, particularly in the community. Comprehensive theory-based nursing care is needed to prevent further complications. Unfortunately, a study combining theory with nursing care in diabetic foot ulcer care has not been explored. When caring for patients with diabetic foot ulcers, who are also at increased risk of severe complications from COVID-19, it is important to take a holistic view of the patient and consider all of their needs and the factors affecting them. Henderson's Need Theory and the 14 basic needs contained within it was chosen to be integrated in the care of patients with diabetic foot ulcers during the pandemic, with the hope that the findings will help nurses to optimise care in both hospital-based and community practice.
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Affiliation(s)
- Sumarno Adi Subrata
- Nursing Lecturer, Center of Research and Community Empowerment (LPPM)/Wound Study Center (WOSCE), Universitas Muhammadiyah Magelang, Indonesia
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Meyer L, Flocard M, Fabacher T, Bahougne T, Ortéga F, Paris D, Munch M, Boullu-Sanchis S, Canel C, Chappaz C, Amoura L, Meyer N, Kessler L. Metabolic Benefit of Teleconsultation for Diabetes Management During the COVID-19 Pandemic: A French Observational Prospective Study. Telemed J E Health 2022; 29:612-616. [PMID: 35944265 DOI: 10.1089/tmj.2022.0090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Aim: To investigate the impact of teleconsultation on glycemic control in patients with diabetes during the COVID-19 pandemic. Methods: In this observational prospective study, the main outcome was the comparison of glycated hemoglobin (HbA1c) between patients with or without teleconsultation at 6-month follow-up. Results: From March 17 to May 31, 2020, 610 patients were included, 456 were followed-up using Teleconsultation présent (TC+) and 154 not using No Teleconsultation (TC-). Patients of TC+ Group were younger, 57 ± 17 versus 65 ± 15.5 years (p < 0.001), with a lower body mass index, 28 ± 6.2 kg/m2 versus 30 ± 5.8 kg/m2, compared to those of TC- Group (p < 0.001). HbA1c were comparable between the two groups: 7.35 ± 0.27% for TC+ versus 7.48 ± 0.22% for TC- Group. At 6-month follow-up, HbA1c was lower in TC+ versus TC- Group: 7.21 ± 0.15% versus 7.6 ± 0.18% (p = 0.004). Conclusion: Our findings point toward the feasibility and usefulness of teleconsultation for the follow-up of patients with diabetes in such exceptional circumstances.
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Affiliation(s)
- Laurent Meyer
- Department of Endocrinology Diabetes and Nutrition, University Hospital, Strasbourg, France.,Private Center of Endocrinology and Diabetology, Strasbourg, France
| | - Mathilde Flocard
- Department of Endocrinology Diabetes and Nutrition, University Hospital, Strasbourg, France
| | - Thibault Fabacher
- Department of Biostatistic and Public health, University Hospital, Strasbourg, France
| | - Thibault Bahougne
- Department of Endocrinology Diabetes and Nutrition, University Hospital, Strasbourg, France
| | - Françoise Ortéga
- Department of Endocrinology Diabetes and Nutrition, University Hospital, Strasbourg, France
| | - Dominique Paris
- Department of Endocrinology Diabetes and Nutrition, University Hospital, Strasbourg, France
| | - Marion Munch
- Department of Endocrinology Diabetes and Nutrition, University Hospital, Strasbourg, France
| | | | - Clémence Canel
- Private Center of Endocrinology and Diabetology, Strasbourg, France
| | - Claire Chappaz
- Private Center of Endocrinology and Diabetology, Strasbourg, France
| | - Lamia Amoura
- Department of Endocrinology Diabetes and Nutrition, University Hospital, Strasbourg, France
| | - Nicolas Meyer
- Department of Biostatistic and Public health, University Hospital, Strasbourg, France
| | - Laurence Kessler
- Department of Endocrinology Diabetes and Nutrition, University Hospital, Strasbourg, France.,Inserm UMR 1260, Regenerative Nanomedicine, University of Strasbourg France, Strasbourg, France
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Kowall B, Kostev K, Landgraf R, Hauner H, Bierwirth R, Rathmann W. Effects of the COVID-19 pandemic on clinically diagnosed psychiatric disorders in persons with type 2 diabetes. Diabet Med 2022; 39:e14852. [PMID: 35426166 PMCID: PMC9111356 DOI: 10.1111/dme.14852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
AIMS To examine whether the incidence rates of diagnosed depression, anxiety disorders and stress reactions, as well as prescription rates of antidepressants and anxiolytics were higher during the COVID-19 pandemic than before in persons with type 2 diabetes in Germany. Contrary to earlier studies, clinical diagnoses of psychiatric disorders (ICD classification) were used. METHODS The German Disease Analyzer (DA) database is an outpatient database containing routine data on patients´ diseases and treatments provided by a representative panel of physician practices selected from across Germany. We assessed incidence rates of depressive disorders (ICD-10: F32, F33), anxiety disorders (F41) and stress reactions (F43) in quarters from January 2019 to March 2021 in 95,765 people with type 2 diabetes included in the DA in 2019 (mean age 68.9 years, 58% men). Prescription rates of antidepressants and anxiolytics in quarters from January 2020 to March 2021 were compared with prescription rates from 1 year earlier. RESULTS During the study period, the incidence rate of newly diagnosed depressive disorders in persons with type 2 diabetes declined slightly, while the incidence rates of anxiety and stress disorders remained largely constant. The rates of new prescriptions for antidepressants and anxiolytics were lower in all quarters of 2020 and in the first quarter of 2021 than in the quarters 1 year earlier. Diabetes-related complications were more prevalent in persons with incident psychiatric disorders than in those without. CONCLUSIONS No increase in the incidence rates of clinically diagnosed psychiatric disorders was observed during the COVID-19 pandemic in Germany in persons with type 2 diabetes.
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Affiliation(s)
- Bernd Kowall
- Institute for Medical Informatics, Biometry and EpidemiologyUniversity Hospital EssenEssenGermany
| | | | | | - Hans Hauner
- Institute of Nutritional MedicineSchool of MedicineTechnical University of MunichMunichGermany
| | | | - Wolfgang Rathmann
- Institute for Biometrics and EpidemiologyGerman Diabetes CenterLeibniz Center for Diabetes Research at Heinrich Heine University DüsseldorfDüsseldorfGermany
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THE EFFECT OF ANXIETY LEVELS OF TYPE 2 DIABETES MELLITUS PATIENTS ON THEIR TREATMENT ADHERENCE IN THE COVID-19 PANDEMIC PERIOD. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2022. [DOI: 10.33457/ijhsrp.1115603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This study was conducted to investigate the effects of the anxiety levels of Diabetes Mellitus (DM) patients on their treatment adherence in the COVID-19 pandemic period. The sample of this descriptive and cross-sectional study consisted of 313 DM patients who presented to the internal medicine outpatient clinic between 01.01.2021 and 01.02.2021. The data were collected using a Personal Information Form, the Coronavirus Anxiety Scale (CAS), and the Morisky Medication Adherence Scale (MMAS-8). Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test and Spearman’s correlation test were used to analyze the data. The mean CAS score of the DM patients was 7.89±3.87, while their mean total MMAS-8 score was 4.06±1.56. It was determined that the patients who were using oral antidiabetic medications, those adhering to their medication and diet treatment, and those who were not COVID-19 had higher levels of anxiety. There was a negative significant relationship between the MMAS-8 and CAS scores of the patients (p
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Ueland GÅ, Ernes T, Vonheim Madsen T, Husebye ES, Sandberg S, Fjell Løvaas K, Cooper JG. Fear of Covid 19 during the third wave of infection in Norwegian patients with type 1 diabetes. PLoS One 2022; 17:e0272133. [PMID: 35901064 PMCID: PMC9333287 DOI: 10.1371/journal.pone.0272133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/12/2022] [Indexed: 01/08/2023] Open
Abstract
Objective
To study the fear of Covid 19 infection among Norwegian patients with type 1 diabetes.
Research design and methods
Fear of Covid 19 scale, a validated scale assessing the fear of Covid 19, was sent electronically to 16255 patients with type 1 diabetes in May 2021. The items are rated on a scale from 1 to 5 (total scores from 7 to 35). The higher the score, the greater the fear.
Results
10145 patients, 52% of the Norwegian adult type 1 diabetes population, completed the questionnaire. The mean total fear score was 13.8 (SD 5.8). Women experienced more fear than men (OR 1.96), and fear increased significantly with increasing age for both genders (p<0.05). Fear increased with increasing BMI, more pronounced for men than women. Fear was positively correlated to HbA1c (Spearman rho 0.067, p<0.05), and significantly increased in patients with micro- and macrovascular complications, compared with patients without complications (p<0.05). Smokers showed increased fear compared with non-smokers, (1.59 (1.39–1.81)), and non-European patients reported more fear than Europeans (OR of 2.02 (95% CI 1.55–2.63).
Conclusion
Assessment of fear of Covid 19 in the type 1 diabetes population in Norway revealed an overall low fear during the third wave of infection. Patients considered to be at high risk of serious disease, such as older individuals, smokers and obese individuals expressed more fear than low risk individuals. The degree of fear was also associated with sex, ethnicity, educational/working status, glycemic control and presence of complications.
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Affiliation(s)
- Grethe Åstrøm Ueland
- Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- * E-mail:
| | - Tony Ernes
- Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Tone Vonheim Madsen
- Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Eystein Sverre Husebye
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Scinece, University of Bergen, Bergen, Norway
| | - Sverre Sandberg
- Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Karianne Fjell Løvaas
- Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - John Graham Cooper
- Norwegian Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Medicine, Stavanger University Hospital, Stavanger, Norway
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Schmid F, Schmitt A, Hermanns N, Kulzer B, Ehrmann D. Psychosocial Impact of the COVID-19 Pandemic on People With Type 1 Diabetes: Results of an Ecological Momentary Assessment Study. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:834643. [PMID: 36992727 PMCID: PMC10012070 DOI: 10.3389/fcdhc.2022.834643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/09/2022] [Indexed: 11/13/2022]
Abstract
AimsPsychological distress due to living with diabetes, demanding self-management tasks, impacts on life, and risks of complications is common among people living with diabetes. COVID-19 could pose a new additional risk factor for psychological distress in this group. This study aimed to analyze levels of COVID-19-related burdens and fears, variables explaining these levels, and associations with the concurrent 7-day COVID-19 incidence in people with type 1 diabetes (T1D).MethodsA total of 113 people with T1D (58% women; age: 42.3 ± 9.9 years) participated in an ecological momentary assessment (EMA) study between December 2020 and March 2021. The participants reported daily levels of COVID-19-related burdens and fears over 10 consecutive days. Global ratings of COVID-19-related burdens and fears were assessed using questionnaires, as were current and previous levels of diabetes distress (PAID), acceptance (DAS), fear of complications (FCQ), depressive symptoms (CES-D), and diabetes self-management (DSMQ). Current levels of diabetes distress and depressive symptoms were compared with pre-pandemic ratings gained during an earlier study phase. Associations between burdens and fears, psychosocial and somatic aspects, and the concurrent 7-day incidence rate were analyzed using multilevel regression.ResultsDiabetes distress and depressive symptoms reported during the pandemic were comparable to pre-pandemic levels (PAID: p = .89; CES-D: p = .38). Daily EMA ratings reflected relatively low mean COVID-19-related burdens and fears in everyday life. However, there was substantial day-to-day variation per person indicating higher burdens on specific days. Multilevel analyses showed that daily COVID-19-related burdens and fears were significantly predicted by pre-pandemic levels of diabetes distress and diabetes acceptance but were not associated with the concurrent 7-day incidence rate nor with demographic and medical variables.ConclusionsThis study observed no increase in diabetes distress and depressive symptoms during the pandemic in people with T1D. The participants reported low to moderate levels of COVID-19-related burdens. COVID-19-related burdens and fears could be explained by pre-pandemic levels of diabetes distress and acceptance but not by demographic and clinical risk variables. The findings suggest that mental factors may constitute stronger predictors of COVID-19-related burdens and fears than objective somatic conditions and risks in middle-aged adults with T1D.
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Affiliation(s)
- Fabienne Schmid
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Diabetes Center Mergentheim (DCM), Bad Mergentheim, Germany
| | - Andreas Schmitt
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Diabetes Center Mergentheim (DCM), Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
| | - Norbert Hermanns
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Diabetes Center Mergentheim (DCM), Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Bernhard Kulzer
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Diabetes Center Mergentheim (DCM), Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Dominic Ehrmann
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Diabetes Center Mergentheim (DCM), Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
- *Correspondence: Dominic Ehrmann,
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Sánchez Conejero M, González de Buitrago Amigo J, Tejado Bravo ML, de Nicolás Jiménez JM. Impact of COVID-19 lockdown on glucemic control in children and adolescents with type 1 diabetes mellitus. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2022; 97:22-29. [PMID: 35725820 PMCID: PMC9186430 DOI: 10.1016/j.anpede.2020.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 12/30/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIMS To face the rapid spread of SARS-CoV2 coronavirus pandemic, home lockdown in Spain was decreed on 15th March 2020. The main objective of this study is to evaluate the impact of this constraint on glycemic control in children and adolescents with type 1 diabetes mellitus (T1D). PATIENTS AND METHODS Observational, retrospective study in children and adolescents with T1D users of interstitial glucose monitoring systems. The following information corresponding to the last 2 weeks of lockdown was collected for subsequent comparison with data of 2 weeks prior to quarantine: daily insulin needs, mean interstitial glucose, estimated HbA1c, coefficient of variation (CV), time in range (70-180mg/dl), hypoglycemia (<70 and <54mg/dl) and hyperglycemia (>180 and> 250mg/dl), sensor use and number of blood glucose measurements. Data about meal routines, physical exercise, need for adjustments in therapy, acute complications and lockdown of caregivers were assessed via a survey. RESULTS 80 patients were studied (mean age 12.61±3.32 years, mean time of evolution of the disease 5.85±3.92 years), 66.2% treated with an insulin pump, users of following glucose monitoring systems: Guardian 3 (65%), FreeStyle Libre (18.8%) and Dexcom G6 (16.2%). Time in range in the cohort increased significantly during confinement (72.1±10.5 vs 74.8±10.5%; P=0.011) with lower time in hypoglycemia both <70mg/dl (4.6±3.2 vs 3.2±2.7%; P<0.001) and <54mg/dl (1.2±1.6 vs 0.7±1.2%; P<0.001) and hyperglycemia >250mg/dl (4.6±3.9 vs 3.7±3.7%; P=0.038). CV also decreased (35.8±6.3 vs 33.1±6.1%; P<0.001). Patients treated with multiple doses of insulin and poorer baseline glycemic control experienced greatest improvement. Daily insulin requirements remained stable. Regular practice of physical exercise and caregivers' confinement did not have a significant impact. CONCLUSIONS Glycemic control in children and adolescents with T1D improved during quarantine, particularly in those with worse baseline control.
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Lear-Claveras A, Oliván-Blázquez B, Clavería A, Couso-Viana S, Botaya RM. Analysis of Clinical Parameters, Drug Consumption and Use of Health Resources in a Southern European Population with Diabetes That Did Not Contract COVID-19: A Longitudinal Big Data Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116835. [PMID: 35682418 PMCID: PMC9180049 DOI: 10.3390/ijerph19116835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 12/23/2022]
Abstract
The lockdown measures imposed to stop the spread of the virus have affected the general population, but particularly people with chronic diseases such as diabetes. An observational real world data pre-post study of 86,615 individuals over the age of 16, having a medical history in the Aragon (Spain) Health Service and diagnosed with diabetes, without COVID-19 infection was undertaken. Clinical, pharmacological and health resource use variables were collected during the six months prior to the onset of the lockdown and during the six months after the lockdown ended. The Student's t-test was used to analyse differences in means. Our study does not show clinically relevant changes six months following the end of the strict lockdown. The consumption, by these patients, of hypoglycaemic drugs and the use of health resources continue at below pre-pandemic levels, six months later. The interruption in care for these patients and the lifestyle change resulting from the pandemic do not appear to have had a significant impact on the health of the diabetic population.
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Affiliation(s)
- Ana Lear-Claveras
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Aragon Health Research Institute, 50015 Zaragoza, Spain; (A.L.-C.); (R.M.B.)
| | - Bárbara Oliván-Blázquez
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Aragon Health Research Institute, 50015 Zaragoza, Spain; (A.L.-C.); (R.M.B.)
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 08007 Barcelona, Spain;
- Correspondence:
| | - Ana Clavería
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 08007 Barcelona, Spain;
- I-Saúde Group, South Galicia Health Research Institute, 36201 Vigo, Spain;
- Vigo Health Area, SERGAS, 36201 Vigo, Spain
| | - Sabela Couso-Viana
- I-Saúde Group, South Galicia Health Research Institute, 36201 Vigo, Spain;
| | - Rosa Magallón Botaya
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Aragon Health Research Institute, 50015 Zaragoza, Spain; (A.L.-C.); (R.M.B.)
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 08007 Barcelona, Spain;
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, 50009 Zaragoza, Spain
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Inglin L, Wikström K, Lamidi ML, Laatikainen T. The adverse effect of the COVID-19 pandemic on health service usage among patients with type 2 diabetes in North Karelia, Finland. BMC Health Serv Res 2022; 22:725. [PMID: 35650580 PMCID: PMC9156619 DOI: 10.1186/s12913-022-08105-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
Aims The COVID-19 pandemic has challenged health systems and their capacity to deliver essential health services while responding to COVID-19. This study examines the pandemic’s impact on health service usage among patients with type 2 diabetes in the North Karelia region, in Finland. Methods This retrospective cohort study used electronic health records of 11,458 type 2 diabetes patients, comprising all primary and specialised care contacts in 2019 and 2020. We analysed diabetes and dental healthcare contacts to primary care nurses, doctors and dentists and all emergency visits in specialised care. We compared healthcare usage in three different periods in 2020 (pre-lockdown [1 January–15 March], lockdown [16 March–31 May], post-lockdown [1 June–31 December]) with the equivalent period in 2019. Results During the lockdown period, the number of diabetes-related contacts decreased significantly but quickly increased again to nearly the same level as in 2019. Overall, healthcare usage was lower in the pandemic year, with proportionally 9% fewer contacts per person (mean 2.08 vs 2.29) and a proportionally 9% lower proportion of patients making any contact (59.9% vs 65.8%). The proportion of remote consultations was similar in both years in the pre-lockdown period (56.3–59.5%) but then increased to 88.0% during the 2020 lockdown. Patterns were similar when analysed by age group and gender. Emergency visits went down significantly at the beginning of the lockdown period, but a “rebound effect” was observed, so after the lockdown, the number of emergency visits in 2020 exceeded the numbers of the previous year. Conclusion Despite the COVID-19 pandemic, diabetes care was continuous, and even elderly patients aged ≥70 years accessed the health services. The delivery of many essential services was facilitated by processes that strongly relied on telemedicine already before the pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08105-z.
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Alzubaidi H, Hafidh K, Saidawi W, Othman AM, Khakpour MM, Zoghbor MM, Abu-Gharbieh E, Alzoubi KH, Shaw JE. Behavioral, psychological, and clinical outcomes of Arabic-speaking people with type 2 diabetes during COVID-19 pandemic. Prim Care Diabetes 2022; 16:355-360. [PMID: 35410850 PMCID: PMC8993045 DOI: 10.1016/j.pcd.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/29/2022] [Indexed: 01/21/2023]
Abstract
AIMS Assess self-care activities, health behaviors, self-efficacy, diabetes distress, challenges, and changes in diabetes treatment and clinical parameters among Arabic-speaking people with T2DM during the COVID-19 pandemic. METHODS A cross-sectional study was conducted at a tertiary hospital in the United Arab Emirates. The study instrument collected self-reported data using validated tools about health behaviors, self-efficacy, and diabetes distress, and challenges in accessing and using healthcare services during the pandemic and documented clinical data and treatment before and during the pandemic from medical records. RESULTS 206 patients participated with a mean age of 58.7 years and 15.7 years since diabetes diagnosis. Non-adherence to healthful eating and exercise was reported by 38.3% and 73.7%, respectively. Exercise was the self-care activity that decreased the most (36.8%). Most participants had low diabetes distress (85.9%). There were no significant differences in clinical parameters before and during the pandemic, and diabetes treatment was unchanged for 72.8% of participants. Having two or more challenges with accessing and using diabetes healthcare services was significantly associated with decreased adherence to healthy eating (p = 0.025) and exercise (p = 0.003). CONCLUSIONS Arabic-speaking people with T2DM appeared to maintain relatively similar self-care levels, except exercise, with no deterioration in clinical parameters compared to pre-pandemic.
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Affiliation(s)
- Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates; Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Khadija Hafidh
- Rashid Hospital, Dubai Health Authority UAE, Dubai Medical College, United Arab Emirates.
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Amna M Othman
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Mahta M Khakpour
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Malaka M Zoghbor
- Pharmacist, Fakeeh University Hospital, Dubai Silicon Oasis, Dubai, United Arab Emirates.
| | - Eman Abu-Gharbieh
- Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Karem H Alzoubi
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Jonathan E Shaw
- Clinical and Population Health, Baker Institute, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Road, PO Box 6492, Melbourne, VIC 3004, Australia.
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Abdoli S, Odoi E, Doosti-Irani M, Fanti P, Beebe LH. Regional Comparison of Diabetes Psychosocial Comorbidities Among Americans With Type 1 Diabetes During the COVID-19 Pandemic. Sci Diabetes Self Manag Care 2022; 48:213-234. [PMID: 35642136 DOI: 10.1177/26350106221102863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to compare diabetes psychosocial comorbidities among adults with type 1 diabetes (T1D) across the United States during the onset of COVID-19 pandemic. METHODS Adults with T1D from 4 main US geographic regions including South (n = 367), West (n = 234), Northeast (n = 250), and Midwest (n = 247) completed a cross-sectional online survey between April and June 2020. Data collection was done on psychosocial measures, glycemic variability, sociodemographic characteristics, and various challenges related to the COVID-19 pandemic. Chi-square, Fisher's exact, Kruskal-Wallis tests, ordinary least squares, proportional odds, and ordinal logistic regression methods were used for data analysis. RESULTS In the South, 51.2% of participants had moderate to high levels of diabetes distress, and this was significantly (P = .03) higher than other regions. Northeast region had the lowest prevalence of moderate to severe diabetes burnout (19.8%), but this was not significantly different compared to the other regions. Participants in the South had also the highest mean score on the 8-item Patient Health Questionnaire, with 30.3% of them reporting moderate to severe depressive symptoms. However, there were no significant differences in depressive symptoms among the regions. Glycemic control, demographic characteristics, and COVID-19-related challenges were associated with different psychosocial comorbidities in different regions. CONCLUSIONS When providing information and support to individuals with diabetes in time of crisis like the COVID pandemic, providers should consider psychosocial aspects of diabetes care. Diabetes disparities and contextual factors vary geographically in the United States; these factors may impact the psychosocial comorbidities of diabetes in each region.
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Affiliation(s)
- Samereh Abdoli
- College of Nursing, University of Tennessee, Knoxville, Tennesse
| | - Evah Odoi
- Department of Public Health, The University of Tennessee, Knoxville, Tennessee
| | - Mehri Doosti-Irani
- Shehr-e-Kourd University of Medical Sciences, Shahre-e-Kourd, Chahar Mahaal and Bakhtia, Iran
| | - Paulo Fanti
- Faculty of Medical Sciences - University of Campinas, Campinas, São Paulo, Brazil
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Troncone A, Chianese A, Cascella C, Zanfardino A, Piscopo A, Rollato S, Iafusco D. Eating Problems in Youths with Type 1 Diabetes During and After Lockdown in Italy: An 8-Month Follow-Up Study. J Clin Psychol Med Settings 2022; 30:227-237. [PMID: 35635607 PMCID: PMC9148941 DOI: 10.1007/s10880-022-09884-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 01/09/2023]
Abstract
AbstractEighty-five youths with T1D and 176 controls aged 8–19 years were asked to complete online questionnaires (ChEAT and EAT-26) measuring disordered eating behaviors (DEBs) during (baseline) and after (8-month follow-up) the lockdown. DEB symptoms in all participants (especially younger than 13 years), glycemic control, and zBMI were found unchanged from baseline to follow-up (all p > .05). After 8 months, the ChEAT/EAT-26 critical score frequency decreased significantly in controls (p = .004), as was the score for the ChEAT/EAT-26’s Oral Control subscale in both groups (T1D: p = .005; controls: p = .01). Participants with T1D, especially those older than 13 years, had higher ChEAT/EAT-26 Dieting scores (p = .037) and lower ChEAT/EAT-26 Oral Control scores (p = .046) than controls. Unchanged DEB symptoms suggest that the COVID-19 restrictions did not significantly affect participants’ eating behaviors and that a general adaptation to the challenges of lockdown and other pandemic containment measures occurred in both T1D and control participants.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Antonietta Chianese
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Crescenzo Cascella
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Angela Zanfardino
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138, Naples, Italy.
| | - Alessia Piscopo
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138, Naples, Italy
| | - Serena Rollato
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138, Naples, Italy
| | - Dario Iafusco
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138, Naples, Italy
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Hammersen J, Reschke F, Tittel SR, Pappa A, Dost A, Köstner K, Rosenbauer J, Kapellen TM, Rohrer TR, Holl RW. Metabolic control during the SARS-CoV-2 lockdown in a large German cohort of pediatric patients with type 1 diabetes: Results from the DPV initiative. Pediatr Diabetes 2022; 23:351-361. [PMID: 35084805 DOI: 10.1111/pedi.13319] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/17/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To assess if metabolic control worsened during the SARS-CoV2 lockdown in spring 2020 in youth with type 1 diabetes (T1D) in Germany. METHODS Data from 19,729 pediatric T1D patients from the diabetes prospective follow-up (DPV) registry were available. Data sets from four time-periods between January 1 and June 30, 2020, were compared with data from the whole year 2019 in the same patient; differences were adjusted for seasonality, increasing age, and longer diabetes duration. HbA1c values from laboratory measurements and estimates derived from continuous glucose monitoring (CGM) were aggregated into a combined glucose indicator (CGI), expressed in analogy to HbA1c. RESULTS Based on regression models adjusted for differences of sex, age, diabetes duration, and migratory background between the four time-periods, CGI values in 2020 were slightly higher than in 2019, for example, by 0.044% (0.042-0.046) (median [95% CI]) in the second lockdown month, time-period 3. Insulin dose and BMI-SDS were also marginally higher. In 2020, there were fewer hospitalizations (e.g., incidence risk ratio in time-period 3 compared with 2019: 0.52 [95% CI: 0.46-0.58]). In a subgroup of patients reporting CGM data in both years, metrics in 2020 improved: time in target increased, and mean sensor glucose fell, for example, by 2.8% (2.7-2.9), and by 4.4 mg/dl (4.3-4.6) in time-period 3. CONCLUSION Before, during, and after the lockdown in spring 2020, metabolic control in youth with T1D in Germany did not differ significantly from the preceding year. Further effects of the ongoing pandemic on pediatric T1D patients need to be evaluated.
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Affiliation(s)
- Johanna Hammersen
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | - Felix Reschke
- Diabetes Center for Children and Adolescents, Children's Hospital Auf der Bult, Hannover, Germany
| | - Sascha R Tittel
- Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany.,German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Angeliki Pappa
- Department of Pediatrics, University Hospital RWTH Aachen, Aachen, Germany
| | - Axel Dost
- Department of Pediatrics, University Hospital Jena, Jena, Germany
| | - Katharina Köstner
- German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - Joachim Rosenbauer
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.,Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Thomas M Kapellen
- Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.,Median Children's Hospital "Am Nicolausholz", Bad Kösen, Germany
| | - Tilman R Rohrer
- Department of Pediatrics, Saarland University Medical Center, Homburg, Germany
| | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany.,German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
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Enea V, Candel OS, Zancu SA, Maftei A, Bîrlădeanu L, Timofte D. Death Obsession, COVID-19-Related Fear and Religiosity in People Living with Type 2 Diabetes. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221085402. [PMID: 35441558 PMCID: PMC9023313 DOI: 10.1177/00302228221085402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients diagnosed with type 2 diabetes were included among high-risk groups for more severe manifestations in case of COVID-19 infection and higher risk of mortality. The current study aims to (1) examine the relationship between death obsession, religiosity, and fear of COVID-19 among type 2 diabetes patients, and (2) assess if religiosity moderates the relationship between death obsession and fear of COVID-19. This cross-sectional online survey involved 306 type 2 diabetes patients. We found that 35.6 % of the participants were overweight and 14.6 % were suffering from obesity. Results showed that death obsession was positively associated with fear of COVID-19 and more religious individuals experience higher levels of fear. The overall level of religiosity did not moderate the relationship between death obsession and fear of COVID-19 but only the preoccupation with God dimension of the religiosity scale. The practical implications of these findings are discussed.
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Affiliation(s)
- Violeta Enea
- Department of Psychology,
Alexandru
Ioan Cuza University, Iasi,
Romania
| | | | | | - Alexandra Maftei
- Department of Psychology,
Alexandru
Ioan Cuza University, Iasi,
Romania
| | - Livia Bîrlădeanu
- Department of Psychology,
Alexandru
Ioan Cuza University, Iasi,
Romania
| | - Daniel Timofte
- Grigore T Popa University of Medicine and
Pharmacy Iasi, Romania
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48
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Pleym K, Iversen MM, Broström A. Experiences and actions related to living with type 1 diabetes during the COVID-19 pandemic in Norway: a qualitative study conducted during July to December 2020. BMJ Open 2022; 12:e056027. [PMID: 35393314 PMCID: PMC8990606 DOI: 10.1136/bmjopen-2021-056027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aim of this study was to describe the experiences of adults with type 1 diabetes (T1DM) during the COVID-19 pandemic in Norway, and what actions they took to cope with the situation. DESIGN An inductive, descriptive design applying the critical incident technique was used to collect qualitative data between July 2020 and December 2020. SETTING A strategic selection was made from diabetes specialist outpatient clinics at three different hospitals in eastern Norway. The hospitals, two community hospitals and one university hospital, were situated in both rural and urban areas. PARTICIPANTS Inclusion criteria were people with T1DM aged 18-65 years. Exclusion criteria were pregnancy, people with chronic pulmonary disorders, people with active cancer diseases and people diagnosed with a myocardial infarction or stroke during the previous 6 months. Semistructured individual interviews with 19 people with T1DM were conducted. RESULTS Experiences were categorised into two main areas: 'increased psychosocial burden of T1DM during the COVID-19 pandemic' and 'changed conditions for T1DM treatment during the COVID-19 pandemic'. Uncertainty distress and social consequences from infection control measures contributed to the burden of T1DM. Disrupted T1DM follow-up and altered daily routines created challenges. However, having increased time to focus on T1DM self-management during lockdown represented an improvement. Actions to handle the situation were categorised into two main areas: 'actions to handle psychosocial strain related to T1DM and COVID-19' and 'actions to handle changed conditions for T1DM treatment during the COVID-19 pandemic'. CONCLUSIONS Patients experienced an increased psychosocial burden of T1DM and difficulties from a disrupted daily life affecting T1DM self-management routines. Uncertainty-reducing behaviours and actions to adapt to the situation provided a general sense of coping despite these difficulties. Tailored information and follow-up by telephone or video call was emphasised to reduce uncertainly distress and support adequate diabetes T1DM self-management.
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Affiliation(s)
- Karin Pleym
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Vestlandet, Norway
- Department of Medicine, Vestre Viken Hospital Trust, Drammen, Norway
| | - Marjolein Memelink Iversen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Vestlandet, Norway
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönkoping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
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Naous E, Boulos M, Sleilaty G, Achkar AA, Gannagé-Yared MH. Quality of life and other patient-reported outcomes in adult Lebanese patients with type 2 diabetes during COVID-19 pandemic. J Endocrinol Invest 2022; 45:763-772. [PMID: 34780052 PMCID: PMC8591152 DOI: 10.1007/s40618-021-01701-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Several studies have shown that COVID-19 pandemic has a negative impact on type 2 diabetic mellitus (T2DM) patients' quality of life (QoL). However, very few studies were performed in Middle Eastern countries. AIM The aim of the current study was to assess, the QoL and diabetes-specific QoL, treatment satisfaction and psychological distress of Lebanese patients with T2DMs using: the Audit of Diabetes-Dependent Quality of Life (ADDQoL), Diabetes Treatment Satisfaction Questionnaire status version (DTSQs) and Kessler 10 (K10) questionnaires and to compare results to those obtained during the pre-COVID-19 period. RESULTS 461 patients with T2DM participated in the study; 52.6% men, 47.4% women; median age 59 years old. The respective median ADDQoL and DTSQs scores were - 2.2 (interval interquartile range (IQR) - 3.9, - 0.8) (range from - 9 maximum negative impact to + 3 maximum positive impact) and 30(IQR22-36) (range from 0 maximum dissatisfaction to 36 maximum satisfaction). K10 median score was 26(IQR18-35) (range from minimum score of 10 indicating no distress to maximum score of 50 indicating severe distress). Rural dwelling, lack of exercise, current smoking, diabetic complications, injectable diabetes treatment, and previous COVID-19 infection were all associated with significantly worse ADDQoL, DTSQs, and K10 score indicating greater distress. A significant worsening of ADDQoL scores followed onset of the pandemic with no significant change in DTSQs scores. CONCLUSION During the COVID-19 pandemic, T2DM Lebanese patients experienced more negative impact of diabetes on QoL and mental health. Those infected with COVID-19 also reported worse QoL, treatment satisfaction and mental health. This highlights the need for community and individual support.
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Affiliation(s)
- E Naous
- Department of Endocrinology, Saint-Joseph University, Faculty of Medicine, Beirut, Lebanon.
| | - M Boulos
- Department of Endocrinology, Saint-Joseph University, Faculty of Medicine, Beirut, Lebanon
| | - G Sleilaty
- Department of Biostatistics and Clinical Research Center, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - A A Achkar
- Department of Endocrinology, Saint-Joseph University, Faculty of Medicine, Beirut, Lebanon
| | - M-H Gannagé-Yared
- Department of Endocrinology, Saint-Joseph University, Faculty of Medicine, Beirut, Lebanon
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Peimani M, Bandarian F, Namazi N, Larijani B, Nasli-Esfahani E. Physical Activity Behavior During the COVID-19 Outbreak in Individuals with Type 2 Diabetes: Role of Social Support and Other Covariates. Int J Endocrinol Metab 2022; 20:e120867. [PMID: 36060451 PMCID: PMC9363939 DOI: 10.5812/ijem-120867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/12/2022] [Accepted: 04/24/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES This study was performed to investigate whether social support and other psychological predictors were associated with physical activity during the prolonged social isolation due to the coronavirus disease 2019 outbreak in Iran. METHODS This cross-sectional study was performed on 494 individuals with type 2 diabetes (T2D) in a diabetes specialty clinic. The questionnaire package comprised five parts, including sociodemographic and clinical characteristics, physical activity level, diabetes-specific social support, feelings of isolation, and diabetes-related distress. Clinical and hemoglobin A1c data were obtained from electronic medical records. Descriptive statistics, Pearson's chi-square test, and multivariable logistic regressions were conducted to analyze the data. RESULTS Approximately 71% of the participants participated in low/insufficient levels of physical activity. The participants who received support from family/friends (odds ratio [OR] = 1.77; 95% confidence interval [CI]: 1.47 - 2.74), diabetes care team (OR = 1.42; 95% CI: 1.15 - 1.77), and neighbors (OR = 1.53; 95% CI: 1.20 - 2.08) were more likely to have sufficient physical activity than those who did not receive these supports. There was also an association between physical activity behavior with feelings of isolation and diabetes distress. CONCLUSIONS This study points to the importance of social support as an amplifier mechanism for the maintenance of physical activity behavior in individuals with T2D during critical times.
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Affiliation(s)
- Maryam Peimani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bandarian
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institutes, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazli Namazi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ensieh Nasli-Esfahani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, P. O. Box: 1411713137, Tehran, Iran. Tel : +98-2188631298, Fax : +98-2188220052,
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