ABSTRACT
BACKGROUND: Diabetes-related distress and glycemic control are of a particular concern to primary care physicians because of the impact of the coronavirus disease 2019 pandemic on diabetic patients' lifestyle, psychological well-being and healthcare access. Our aim was to evaluate the relationship between diabetes-related distress and glycemic control in diabetic patients with Type 2 diabetes mellitus (T2DM) in primary care settings during the pandemic. MATERIALS AND METHODS: This cross-sectional study was conducted at primary healthcare clinics in a rural area in Egypt among 430 patients with T2DM during the period from September 2020 to June 2021. All patients were interviewed for their sociodemographic, lifestyle, and clinical characteristics. Diabetes-related distress was measured by the problem areas in the diabetes scale (PAID), where a total score of ≥40 indicated a severe diabetes-related distress. The most recent glycosylated hemoglobin (HbA1c) measurements were used to indicate the glycemic control. Quantile regression model (0.50 quantile) was used to perform the multivariate analysis to identify significant factors associated with HbA1c level. RESULTS: Most of the participants had a suboptimal glycemic control (92.3%), while 13.3% had severe diabetes-related distress. HbA1c level was significantly and positively correlated with the total PAID score and all its sub-domains. Multivariate quantile regression revealed that obesity, multi-morbidity, and severe diabetes-related distress were the only significant determinants of the HbA1c median level. Obese patients had significantly higher median HbA1c compared to patients who were not obese (coefficient = 0.25, P < 0.001). Patients with two or more comorbidities (i.e., multimorbidity) had a significantly higher median HbA1c than patients with single or no chronic comorbidities (coefficient = 0.41, P < 0.001). Severe diabetes-related distress was significantly associated with higher median HbA1c compared to nonsevere diabetes-related distress (coefficient = 0.20, P = 0.018). CONCLUSION: Diabetes-related distress had a significant association with HbA1c level. Family physicians should implement multifaceted programs to optimize diabetes control and reduce any associated distress.
ABSTRACT
This special issue consists of 12 papers that explore how synergistic connections between COVID-19 and many health and well-being variables unfolded across the world with different vulnerable populations, including survivors of sexual assault, people with disabilities, college students, Black Americans, caregivers, survivors of domestic violence, pregnant women, and people living in low-income neighborhoods.
ABSTRACT
The COVID-19 pandemic and subsequent governmental restrictions have had a major impact on the daily lives of Austrians and negatively affected their mental health. A representative sample of N = 1505 individuals was recruited via Qualtrics® to participate in an online survey between 23 December 2020 and 4 January 2021. A qualitative study design was used to determine the problem areas that emerged since the beginning of the pandemic (question 1), the factors that were the source of the greatest current concern (question 2), the biggest worries when thinking about the future (question 3), and what the most important source of support (question 4) during the pandemic was. The written responses were analyzed using conventional content analysis following a framework for qualitative research and reported in the form of descriptive statistics. Restrictions imposed by the government, sociopolitical developments, work- and health-related issues, and economic disruptions were identified as being the greatest concerns. Conversely, social contacts within and outside the family were the most important source of support, followed by recreational activities and distraction. Greater consideration should be given to psychosocial factors in future decisions to contain the pandemic. More detailed qualitative research, in particular, to collect the personal experience of more vulnerable groups such as young people, women, and the unemployed, is needed.