ABSTRACT
Introduction:/ Objectives: The aim of this study was to explore the short- and longterm impact of the COVID-19 pandemic on self-reported changes in treatment. The early impact and the impact one year after the start of the pandemic was explored in this study. Methods: Pediatric patients and their parents in the diabetes center in Leuven were asked to complete an online questionnaire, securely attached to their medical files. They received the questionnaire for the first time (T1) 4 weeks after the first lockdown in Belgium. Exactly one year later (T2), the same questionnaire was sent. The questionnaire covered changes in diabetes treatment, more specifically insulin injections, glycaemia measurements, nutrition, exercise and general diabetes care. Results: At T1, 33 adolescents (A) and 96 parents (P) of 84 children completed the questionnaire. At T2, 28 adolescents and 95 parents of 83 children completed the questionnaire. At T1, changes in treatment were mostly positive, including extra glycemia measurements (A: 45,5%;P: 40,6%), better adaptation of insulin dosage according to diet and glycemic values (A: 72,7,5%;P: 65,6%), healthier meal choices (A: 66,7%;P: 52,1%), and improved glycemic control (A: 78,1%;P: 58,4%). Many reported to have a different daily structure. At T2, changes in treatment were variable. 39,5% of the adolescents reported to do more glycemia measurements, insulin doses were better adapted (A: 57,1%;P: 34,4%) and healthier meal choices were made (A: 53,6%;P: 40,9%). Less people reported having better metabolic control (A: T1 = 78,1%, T2 = 42,9%;P: T1 = 58,4%, T2 = 33,3%) and having a different daily structure. Conclusions: Self-reported changes in treatment were overall positive at T1, indicating resilience in self-management in patients with type 1 diabetes and their parents in the early stage of the international pandemic. Positive effects on self-reported changes in treatment lasted until T2 but their effect waned. Further research is necessary to elucidate the cause of these changes.
ABSTRACT
Background: Little is known about the COVID-19 pandemic on pediatric patients with type 1 diabetes (T1D). The aim of this study was to explore the early impact of COVID-19 on emotional well-being of pediatric patients and their parents and self-reported changes in treatment since the COVID-19 pandemic. Methods: Pediatric patients with T1D (12-18 years old) and parents of children with T1D. (1-18 years old) in follow-up in the University Hospital of Leuven, completed an online questionnaire, securely attached to their medical files. The questionnaire covered the emotional impact of the COVID- 19 pandemic, changes in diabetes treatment, health-protective behaviors, diabetes-related worries and respondents' perception of their COVID-19 status. Frequencies were calculated for all questions. Results: In total, 33 adolescents and 96 parents of 84 children completed the questionnaire. We documented an impact on emotional well-being, with respondents reporting stress and fear associated with the pandemic. Changes in treatment were mostly positive, including extra glycemia measurements, better adaptation of insulin dosage, healthier eating, and improved glycemic control. Respondents indicated that they followed social distancing rules strictly, worried more about their diabetes and discussed more with each other about the diabetes. Conclusions: The psychological impact of the COVID-19 pandemic in patients and parents was clear, mostly resulting in symptoms of stress and anxiety. This knowledge shows that there is a crucial role for multidisciplinary teams to screen for mental health problems and a need for psychosocial support to reduce levels of stress and anxiety. Self-reported changes in treatment were overall positive, indicating to resilience in self-management in patients with type 1 diabetes and their parents in the early stage of the international pandemic.