ABSTRACT
Introduction The management of teenagers with diabetes during the COVID-19 pandemic has become more challenging with the negative psychosocial impact brought upon by the pandemic. Methodology We embarked on a cross-sectional study to identify the factors influencing glycaemic control (HbA1c) among teenagers with diabetes during the COVID-19 pandemic. Interviews regarding lifestyle changes were conducted among teenagers with type 1 (T1DM) and type 2 diabetes mellitus (T2DM), followed by the administration of the Depression, Anxiety, and Stress Scale (DASS-21). Results A total of 59 adolescents with T1DM (32 males, 54.2%) and 31 patients with T2DM (10 males, 32.3%) were recruited. Overall, the HbA1c worsened from 9.13% before the COVID-19 pandemic to 9.33% during the pandemic (p-value 0.039). Significant factors which negatively influenced glycaemic control were male sex, puberty, prolonged screen time, presence of symptoms of anxiety/stress, and T2DM. However, skipping breakfast, sleep adequacy and physical activity did not directly influence the HbA1c. About one-third of the participants suffered from some form of mental disturbance (31.1% of patients had depressive symptoms, 38.9% of patients had anxiety symptoms, and 23.3% of patients experienced stress). The incidence of depression was higher among participants with T2DM, while anxiety and stress were higher among those with T1DM. Male gender, good glycaemic control pre-pandemic, and prepubertal status were associated with depressive symptoms during the pandemic. Conclusion Besides the disruption of daily routine, glycaemic control worsened among diabetic adolescents during the COVID-19 pandemic. A holistic management plan is needed to address the psychosocial concerns of this group to ensure optimal mental well-being and appropriate glycaemic control.
ABSTRACT
BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, various adverse skin reactions to long-term mask wearing have been reported. AIM: To assess the clinical features of mask-induced dermatoses and to recommend prevention and treatment options. METHODS: From April to August 2020, questionnaires including topics such as demographic information, pre-existing skin disorders, reported mask-related symptoms, daily mask-wearing duration and frequency, types of masks used and whether the participant was a healthcare worker, were distributed to patients in 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis and recorded treatments. RESULTS: Itchiness was the most frequent symptom, mostly affecting the cheeks. The most common skin disease was new-onset contact dermatitis (33.94%), followed by new-onset acne (16.97%) and worsening of pre-existing acne (16.97%). Daily wearing of masks was significantly (P = 0.02) associated with new-onset contact dermatitis. More than half of patients with pre-existing skin problems experienced disease worsening while wearing masks. Longer duration of wearing (> 6 h/day, P = 0.04) and use of cotton masks (P < 0.001) significantly increased acne flare-up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical treatment. The study had some limitations: the effect of seasonal characteristics and other risk factors were not assessed, and the patients were visiting dermatological clinics and had interest in their skin status, thus, there may have been selection bias. CONCLUSION: Mask-induced/-triggered dermatoses contribute to increase the dermatological burden during the pandemic.