ABSTRACT
Introduction: T1D management, age-related stressors and the COVID-pandemic may impair sleep for young adults with T1D. Disparities in A1c and exposure to life stressors may contribute to poorer sleep among people from minoritized racial/ethnic groups. We aimed to describe sleep, correlations with A1c, and sleep patterns across racial/ethnic groups in young adults with T1D during the pandemic. Methods: Young adults with T1D (n=37, M age=20.2±1.6 yrs, 57% female, M A1c=8.9±2.4%) completed an adapted Pittsburgh Sleep Quality Index and 1 sleep-related question from a COVID-questionnaire at baseline of a behavioral trial. Results Overall, 41% endorsed worse sleep during the pandemic, which was correlated with poorer sleep quality (r=-.69, p<.001) and shorter sleep duration (r=-.35, p=.04) . Higher A1c was linked with less frequent T1D management-related sleep disruptions (r=-.44, p=.007) . There were no significant differences in sleep variables among racial/ethnic groups. See Table for sleep descriptions for each racial/ethnic group. Conclusions: Young adults with T1D experienced disrupted sleep, worsened by the pandemic. Clinicians should counsel patients about optimizing sleep and overnight diabetes management, especially those with higher A1c. While small sizes reduced power to detect group differences, initial patterns suggest a need for future research examining disparities in sleep for young adults with T1D.
ABSTRACT
Objective: Vaccination can help prevent COVID-infection and serious health complications. This is particularly important for people with diabetes, who may be at higher risk for COVID-complications. While unvaccinated adults tend to be younger in general, there are no data on vaccine attitudes or uptake in young adults with T1D. We explored vaccine uptake in young adults with T1D across demographic and clinical factors and identified common reasons for not getting the vaccine. Methods: At baseline of an ongoing behavioral intervention trial (Feb-Dec 2021) , 35 young adults with T1D (M age= 20.2±1.6, 57% female, 54% non-Hispanic White, 23% Hispanic, 9% Black, 14% other/multiple, M A1c=8.9±2.4%) reported on vaccination status. Unvaccinated participants provided open-text comments on their reasons. Results: Overall, 69% of participants were vaccinated (2 doses) . Unvaccinated participants had higher median A1c than vaccinated participants (9.7% vs. 7.6%, p=0.03) ;every 1.0% increase in A1c was associated with 22.2% decreased odds of being vaccinated. There were no differences in vaccine uptake by age, gender, race/ethnicity, education, employment, pump or CGM use, or health insurance. The unvaccinated participants reported reasons including: distrust of the vaccine research/effectiveness (4) , uncertainty about health impacts (including T1D) /waiting to see impact on others' health (2) , no time to get vaccinated (1) , indifference (1) , no desire for vaccination (2) , and still thinking about it (1) . Conclusion: In a small, diverse sample of young adults with T1D, COVID-vaccinations mirrored national rates. Some participants may have been vaccinated after completing surveys at baseline. Patterns of high A1c and unvaccinated status may place young adults at increased risk as the pandemic continues. Healthcare providers are well positioned to counsel young adults about vaccine information and considerations related to T1D, which may reduce misinformation and increase uptake.
ABSTRACT
Introduction: Parents of youth with T1D have poorer sleep due to T1D management and worries. During the COVID-19 pandemic, managing T1D may be more demanding and new stressors and routines can impact sleep. We compared parental sleep pre-pandemic to the initial months of the pandemic. Methods: Parents (n=100, 98% mothers) of youth with T1D (M age = 6.7±1.6 yrs, M duration = 2.9±.5 yrs) who were in a behavioral RCT completed surveys at RCT completion and ≥ 6 months later in June/July 2020. They completed the Pittsburgh Sleep Quality Index (PSQI) adapted to include T1D-related sleep questions, and 2 sleep items from a COVID-19 survey. M A1c at RCT completion = 8.2±1.4. We compared pre-pandemic vs. 2020 data using χ2 and t tests. Results: Many parents (40%) reported moderate-extreme difficulty sleeping during the pandemic. From pre- to during the pandemic, PSQI Latency scores increased significantly and Duration and Daytime Dysfunction decreased. More parents had PSQI Global Scores above the clinical cut-off during the pandemic. See Table for details. Conclusions: Parents of children with T1D experienced increased sleep challenges during the COVID-19 pandemic, despite lower T1D-related disruption and daytime impairment. Nighttime T1D management may have been less disruptive as parents slept less. Parental sleep warrants clinical attention as it impacts psychosocial well-being and T1D management for families.
ABSTRACT
OBJECTIVE: The current study explored pre-pandemic sociodemographics, medical characteristics, social/family support, and mood symptoms, and current COVID-19 experiences as predictors of mood, positive/negative diabetes-specific experiences, and COVID-19-specific distress among parents of children with type 1 diabetes during the COVID-19 pandemic. We hypothesized that parents from marginalized backgrounds, youth with higher pre-pandemic A1c and no CGM use, parents with lower pre-pandemic social/family support and more pre-pandemic mood/anxiety symptoms, and those with more negative COVID-19 experiences would have more depressive symptoms, fewer positive and more negative diabetes-specific experiences, and more COVID-19-specific distress during the initial months of the pandemic. RESEARCH DESIGN AND METHODS: Participants were parents of early school-age children with type 1 diabetes (n = 100; 65% non-Hispanic, white, 92% mothers, 75% married; Mchild age = 6.74 ± 1.59 years) who had completed a behavioral intervention trial ≥6 months ago and were re-contacted in June/July 2020 to report on their COVID-19 pandemic experiences and parent psychosocial outcomes. Pre-pandemic parent mood/anxiety symptoms, family/social support, and children's medical characteristics (CGM use; MA1C = 8.17% ± 1.40%) were assessed M = 1.45 ± 0.59 years prior. RESULTS: More pre-pandemic social support predicted fewer depressive symptoms, more positive diabetes-specific experiences, and less COVID-19-specific distress during the pandemic. More pre-pandemic depressive symptoms predicted more depressive symptoms during the pandemic. More life disruptions due to the pandemic were associated with more negative diabetes-specific experiences and more COVID-19-specific distress. Parents of color had more negative diabetes-specific experiences. CONCLUSIONS: Social support may be particularly important to assess and address through intervention. Pediatric diabetes care providers should monitor parent experiences in relation to children's diabetes management. ClinicalTrials.gov identifier: NCT02527525.