ABSTRACT
As the COVID-19 pandemic has disrupted daily life, it is important to understand its effects on youth with T1D. The COVID-19 Exposure and Family Impact Survey (CEFIS) was used to examine COVID-19 effects on diabetes metrics in a pediatric T1D population. Parents of youth with T1D (n=108;mean age 11.6±4 yrs, mean T1D duration 5.3±3.9yrs, 57.4% male) completed the CEFIS (score ranges: Exposure 0-25, Impact 0-4 with >2.5 indicating negative impact, and Distress 1-10) . CEFIS measures and diabetes metrics (A1c, average glucose, in-person visits vs. telemedicine, and number of cancelled visits) were obtained at baseline, 3, 6, 9, and 12 months. Changes in diabetes metrics and correlations with CEFIS scores were analyzed by anova. Cancelled visit frequency per person decreased from baseline to 3 months and was maintained for the duration of the study (p<0.001) . For every one point increase in CEFIS Impact, A1c increased by 0.3 (0.1%) (p=0.04) . For every one point increase in CEFIS Exposure, average glucose increased by 2.3 (0.7mg/dL) (p=0.002) . High perceived stress from the COVID-19 pandemic from CEFIS Impact and Exposure scores may worsen glycemic outcomes for youth, suggesting that the pandemic had a negative affect regardless of COVID-19 infection. Further studies on perceived stress and effects on diabetes management are needed to determine long term impacts of the COVID-19 pandemic on this population.
ABSTRACT
Diabetes is a risk factor for COVID-19 infection-related complications, increasing fear in this population. The effect of the pandemic on quality of life for youth with type 1 diabetes (T1D) has not been evaluated. Youth with T1D (n=108, mean age 11.6±4.0 yrs, mean T1D duration 5.3±3.9, 57.4% male) and a parent completed surveys at baseline (September to November 2020) and every 3 months for 12 months. Measures included the COVID-19 Exposure and Family Impact Survey ([CEFIS], exposure (range 0-25) , family impact (range 0-4, scores >2.5 indicate negative impact) , distress (range 1-10)) , the PedsQL Diabetes Module (higher score indicates higher quality of life) , and the PROMIS Sleep Disturbance and Sleep-Related Impairment surveys (higher score indicates more problems) . CEFIS impact score remained above 2.5 over 12 months. Parent Proxy PedsQL decreased from 3 to 6 months (p=0.019) and 3 to 12 months (p=0.017) . Parent Proxy PROMIS Sleep-Related Impairment increased from 6 to 12 months (p=0.03) and 9 to 12 months (p=0.004) . PedsQL (parent and child) significantly decreased with increased exposure (p<0.001 and p=0.011) and impact (p<0.001 and p=0.016) . Families of youth with T1D were negatively impacted by the pandemic. Parents reported worsening child quality of life and sleep-related impairment during this time. As the pandemic continues, it is important for health care providers to be mindful of mental health in youth with T1D.
ABSTRACT
The COVID-19 pandemic resulted in unprecedented changes in day-to-day life. In families of youth with type 1 diabetes (T1D), preliminary studies suggest impacts on physical/mental health and diabetes self-management. The COVID-19 Exposure and Family Impact Survey (CEFIS) assesses the impact of the pandemic. Parents of youth with T1D (mean age 11.6 yrs, mean T1D duration 5.3 yrs, 57.4% male) completed the CEFIS. Outcomes include exposure (range 0-25), family impact (range 0-4, scores >2.5 indicate negative impact), and distress (range 1-10). Data were collected at baseline (Sept to Nov 2020) and 3-month follow-up (Dec 2020 to Feb 2021). Exposure scores were relatively low (baseline 7.63±2.56, 3-months 7.50±2.93), however, a negative impact on families was reported at baseline (2.74±0.57) and 3-months (2.71±0.60). Distress was present at baseline and 3-months (range 4.26±2.03 to 4.86±2.05). There were no significant group differences when stratifying baseline scores by age or T1D duration. Despite relatively low exposure, COVID-19 had a negative impact on families of youth with T1D. Similar family impact and distress scores at baseline and 3-months highlight the enduring impact of the pandemic on families almost a year into the pandemic. Additional information is needed on how COVID-19 has impacted T1D management. However, clinicians need to be mindful of the significant distress families may be experiencing as a result of the pandemic.