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1.
J Behav Med ; 45(2): 227-239, 2022 04.
Article in English | MEDLINE | ID: covidwho-1616193

ABSTRACT

People with prediabetes are at risk for type 2 diabetes. They may discount the future delay discounting (DD), and not engage in preventive health behaviors. Episodic future thinking (EFT) can reduce DD when future scenarios are cued, but research is needed to assess long-term effects of EFT and when EFT is not cued. This study tested EFT training compared to control for people with prediabetes enrolled in a 6-month weight loss program on DD, weight, HbA1c, and physical activity. Results showed a reliable EFT effect on reducing DD in cued (p = 0.0035), and uncued DD tasks (p = 0.048), and significant overall changes in weight (p < 0.001), HbA1c (p, 0.001) and physical activity (p = 0.003), but no significant differences in these outcomes by group (p's > 0.05). Sixty-eight percent of the sample ended below the prediabetes HbA1c range. These results suggest that DD can be modified over extended periods, and the effects of EFT can be observed without EFT cues. However, these data do not suggest that changes in weight, HbA1c or physical activity were due to EFT training. The study was initiated before the COVID-19 pandemic which provided the opportunity to compare differences for people treated in-person or remotely. Analyses showed no differences in DD, weight, HBA1c or physical activity outcomes were observed between in-person and remote treatment, suggesting telehealth is a scalable approach to treating prediabetes.


Subject(s)
Delay Discounting , Diabetes Mellitus, Type 2 , Glycated Hemoglobin A , Prediabetic State , Weight Loss , Diabetes Mellitus, Type 2/psychology , Humans , Prediabetic State/psychology , Thinking
2.
J Endocrinol Invest ; 45(4): 763-772, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1516940

ABSTRACT

INTRODUCTION: Several studies have shown that COVID-19 pandemic has a negative impact on type 2 diabetic mellitus (T2DM) patients' quality of life (QoL). However, very few studies were performed in Middle Eastern countries. AIM: The aim of the current study was to assess, the QoL and diabetes-specific QoL, treatment satisfaction and psychological distress of Lebanese patients with T2DMs using: the Audit of Diabetes-Dependent Quality of Life (ADDQoL), Diabetes Treatment Satisfaction Questionnaire status version (DTSQs) and Kessler 10 (K10) questionnaires and to compare results to those obtained during the pre-COVID-19 period. RESULTS: 461 patients with T2DM participated in the study; 52.6% men, 47.4% women; median age 59 years old. The respective median ADDQoL and DTSQs scores were - 2.2 (interval interquartile range (IQR) - 3.9, - 0.8) (range from - 9 maximum negative impact to + 3 maximum positive impact) and 30(IQR22-36) (range from 0 maximum dissatisfaction to 36 maximum satisfaction). K10 median score was 26(IQR18-35) (range from minimum score of 10 indicating no distress to maximum score of 50 indicating severe distress). Rural dwelling, lack of exercise, current smoking, diabetic complications, injectable diabetes treatment, and previous COVID-19 infection were all associated with significantly worse ADDQoL, DTSQs, and K10 score indicating greater distress. A significant worsening of ADDQoL scores followed onset of the pandemic with no significant change in DTSQs scores. CONCLUSION: During the COVID-19 pandemic, T2DM Lebanese patients experienced more negative impact of diabetes on QoL and mental health. Those infected with COVID-19 also reported worse QoL, treatment satisfaction and mental health. This highlights the need for community and individual support.


Subject(s)
COVID-19/psychology , Diabetes Mellitus, Type 2/psychology , Mental Health , Psychological Distress , Quality of Life/psychology , Diabetes Mellitus, Type 2/drug therapy , Female , Humans , Hypoglycemic Agents/therapeutic use , Lebanon , Male , Middle Aged , Pandemics , Patient Reported Outcome Measures , Patient Satisfaction
3.
Pan Afr Med J ; 40: 76, 2021.
Article in English | MEDLINE | ID: covidwho-1497894

ABSTRACT

INTRODUCTION: COVID-19 pandemic has had a greater psychological impact on patients with chronic ailments such as diabetes mellitus, tuberculosis, and HIV/AIDS compared to those without chronic conditions. We explored the psychological impacts of COVID-19 among people living with diabetes mellitus in Ghana. METHODS: this study employed a hospital-based cross-sectional design involving 157 diabetes mellitus patients aged 20 years and above. We assessed diabetes distress by the seventeen-item diabetes stress (DDS17) scale and COVID-19 worries by 3 specific benchmarks: "worry about overly affected due to diabetes if infected with COVID-19", "worry about people with diabetes characterized as a risk group" and "worry about not able to manage diabetes if infected with COVID-19". A close-ended questionnaire was used in data collection. RESULTS: of 157 diabetic patients interviewed, the majority had type 2 diabetes mellitus with known complications and only 42.7% were managing COVID-19 symptoms. The participants showed moderate to high level of COVID-19 specific worry, moderate fear of isolation, and low level of diabetes-associated distress. About 33.8% of the study population expressed a sense of worry towards the pandemic. The logistic regression showed that age, employment status, and presence of other chronic diseases were significantly associated with worries about being overly affected if infected with COVID-19 due to their diabetes status. Age and sex were associated with worries about people with diabetes being characterized as a risk group and age, sex and employment status were associated with participants who were worried about not being able to manage diabetes if infected with COVID-19. CONCLUSION: the general trend indicates a sense of worry among diabetes patients during the COVID-19 pandemic which is associated with poorer psychological health. Clients' education and counseling on COVID-19 are necessary to address some of their concerns to minimize the level of anxiety and emotional stress in these individuals.


Subject(s)
COVID-19/psychology , Diabetes Mellitus, Type 1/psychology , Diabetes Mellitus, Type 2/psychology , Adult , Age Factors , Anxiety/epidemiology , Cross-Sectional Studies , Fear , Female , Ghana , Humans , Male , Mental Health , Middle Aged , Risk Factors , Sex Factors , Stress, Psychological/epidemiology , Surveys and Questionnaires , Young Adult
4.
Nutr Metab Cardiovasc Dis ; 31(11): 3243-3246, 2021 10 28.
Article in English | MEDLINE | ID: covidwho-1401752

ABSTRACT

BACKGROUND AND AIMS: Vaccine Hesitancy (VH) is a relevant obstacle for the COVID-19 vaccination campaign. The aim of this study is to assess the proportion of subjects unwilling to vaccinate among patients with type 1 (T1DM) and 2 (T2DM) diabetes, exploring factors associated with VH. METHODS AND RESULTS: A purposely created interview was delivered from physicians to a consecutive series of adult (>18 years) subjects with diabetes referring to the Diabetes Outpatient Clinic of Careggi Hospital, Florence, from January 1st to April 30th 2021. Out of 502 subjects enrolled, 92 were vaccine hesitant respondents (18.3%); the corresponding figure for T1DM and T2DM was 13.0% (N = 14), and 19.9% (N = 78), respectively. After adjusting for age, higher HbA1c (1.07 [1.02-1.13], p = 0.008) and triglycerides levels (1.03 [1.01-1.06], p = 0.011) were positively associated with VH, among patients with T1DM. At multivariate analysis, after adjusting for age, creatinine, and statin use, patients with T2DM affected by obesity (9.98 [4.89-9.59], p < 0.01) and with lower levels of creatinine (0.36 [0.21-0.54], p = 0.029) were more likely to refuse COVID vaccination. CONCLUSIONS: Hesitancy toward COVID-19 vaccination among subjects with diabetes is not negligible and seems to be more prevalent in individuals with lower adherence to medical prescriptions and/or reduced concerns over their health. This suggests the need for specific interventions to increase awareness and counter prejudices on vaccines.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/therapy , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Vaccination/psychology , Adult , Aged , Aged, 80 and over , COVID-19/psychology , Diabetes Mellitus, Type 1/psychology , Diabetes Mellitus, Type 2/psychology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Multivariate Analysis , SARS-CoV-2 , Surveys and Questionnaires , Vaccination Refusal/psychology
5.
Diabetes Metab Syndr ; 15(5): 102245, 2021.
Article in English | MEDLINE | ID: covidwho-1356197

ABSTRACT

AIMS: It is important to have valid and reliable measures to determine the psychological impact of COVID-19 in patients with diabetes; however, few instruments have been developed and validated for this population. Therefore, the aim of this study was to validate the Scale of Worry for Contagion of COVID-19 (PRE-COVID-19) in a sample of patients with diabetes mellitus (DM). MATERIALS AND METHODS: A total of 219 patients (66.2% female, mean age 58.5 SD = 18.2) participated, selected through non-probabilistic sampling. The PRE-COVID-19 and the Generalized Anxiety Disorder Scale-2 were applied. Reliability analysis was performed for internal consistency, structural equation modeling and item response theory modeling. RESULTS: The results show that a unidimensional 5-item model presents satisfactory goodness-of-fit indices and excellent reliability values. Likewise, convergent validity between the PRE-COVID-19 and a measure of anxiety is evident. All items present adequate discrimination parameters, allowing for discerning between those patients with critical concern about COVID-19 contagion from those with severe concern. CONCLUSION: It is concluded that the PRE-COVID-19 is an instrument with adequate psychometric properties to measure concern about COVID-19 infection and the emotional impact in patients with DM.


Subject(s)
COVID-19/psychology , Diabetes Mellitus, Type 2/psychology , Psychometrics/methods , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/etiology , Anxiety Disorders/diagnosis , Anxiety Disorders/epidemiology , Anxiety Disorders/etiology , COVID-19/epidemiology , Cuba/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Psychometrics/standards , Surveys and Questionnaires , Young Adult
6.
Diabet Med ; 38(11): e14665, 2021 11.
Article in English | MEDLINE | ID: covidwho-1334443

ABSTRACT

To investigate and characterise general and diabetes-specific worries related to COVID-19 among people with diabetes in Denmark during the first 3 months of the pandemic. In a longitudinal study from March to June 2020, six online questionnaires (Q1-Q6) were distributed to 2430 adult members of two diabetes panels. Worries related to COVID-19 were measured with closed- and open-ended items. Data from closed-ended items were analysed descriptively. Open-ended responses were analysed with systematic text condensation. Using chi-squared tests, changes in proportions of worries over time were analysed, and differences in diabetes-specific worries by gender and diabetes diagnosis were explored. At Q1, 1366 individuals returned a response (Q2: 1082, Q3: 992, Q4: 977, Q5: 901, Q6: 816). In the beginning of the pandemic, 2 weeks after the first lockdown in Denmark, the most frequently reported general worries related to someone close becoming seriously ill, changes in daily life such as limitations on social interactions and uncertainty about the duration of those changes. The most frequently reported diabetes-specific worries were about severity of illness with COVID-19 due to diabetes, being identified as a member of a group at risk for COVID-19 and being unable to manage diabetes if ill with COVID-19. All concerns decreased over 3 months, as the society gradually reopened, except for persistent worries about being able to manage diabetes if ill with COVID-19. More women and people with type 1 diabetes reported worries, compared with men and people with type 2 diabetes. Our study highlights the diversity of worries related to the COVID-19 pandemic among people with diabetes and changing patterns of worry over time and across subgroups as the society reopened in Denmark. These insights can be helpful when providing support for people with diabetes during health crises.


Subject(s)
Anxiety/psychology , COVID-19 , Diabetes Mellitus, Type 1/psychology , Diabetes Mellitus, Type 2/psychology , Self-Management/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Denmark , Female , Humans , Longitudinal Studies , Male , Middle Aged , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Surveys and Questionnaires , Young Adult
8.
Diabet Med ; 38(9): e14611, 2021 09.
Article in English | MEDLINE | ID: covidwho-1247167

ABSTRACT

AIM: To examine psychosocial and behavioural impacts of the novel coronavirus disease 2019 (COVID-19) pandemic and lockdown restrictions among adults with type 2 diabetes. METHODS: Participants enrolled in the PRogrEssion of DIabetic ComplicaTions (PREDICT) cohort study in Melbourne, Australia (n = 489 with a baseline assessment pre-2020) were invited to complete a phone/online follow-up assessment in mid-2020 (i.e., amidst COVID-19 lockdown restrictions). Repeated assessments that were compared with pre-COVID-19 baseline levels included anxiety symptoms (7-item Generalised Anxiety Disorder scale [GAD-7]), depressive symptoms (8-item Patient Health Questionnaire [PHQ-8]), diabetes distress (Problem Areas in Diabetes scale [PAID]), physical activity/sedentary behaviour, alcohol consumption and diabetes self-management behaviours. Additional once-off measures at follow-up included COVID-19-specific worry, quality of life (QoL), and healthcare appointment changes (telehealth engagement and appointment cancellations/avoidance). RESULTS: Among 470 respondents (96%; aged 66 ± 9 years, 69% men), at least 'moderate' worry about COVID-19 infection was reported by 31%, and 29%-73% reported negative impacts on QoL dimensions (greatest for: leisure activities, feelings about the future, emotional well-being). Younger participants reported more negative impacts (p < 0.05). Overall, anxiety/depressive symptoms were similar at follow-up compared with pre-COVID-19, but diabetes distress reduced (p < 0.001). Worse trajectories of anxiety/depressive symptoms were observed among those who reported COVID-19-specific worry or negative QoL impacts (p < 0.05). Physical activity trended lower (~10%), but sitting time, alcohol consumption and glucose-monitoring frequency remained unchanged. 73% of participants used telehealth, but 43% cancelled a healthcare appointment and 39% avoided new appointments despite perceived need. CONCLUSIONS: COVID-19 lockdown restrictions negatively impacted QoL, some behavioural risk factors and healthcare utilisation in adults with type 2 diabetes. However, generalised anxiety and depressive symptoms remained relatively stable.


Subject(s)
COVID-19/prevention & control , COVID-19/psychology , Communicable Disease Control/methods , Diabetes Mellitus, Type 2/psychology , Health Behavior , Psychology/statistics & numerical data , Aged , Anxiety/epidemiology , Australia/epidemiology , COVID-19/epidemiology , Cohort Studies , Depression/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Exercise/psychology , Female , Humans , Male , Mental Health/statistics & numerical data , Middle Aged , Pandemics , Patient Isolation/psychology , Quality of Life/psychology , SARS-CoV-2 , Social Isolation/psychology
9.
Endocrinol Diabetes Metab ; 4(3): e00249, 2021 07.
Article in English | MEDLINE | ID: covidwho-1222611

ABSTRACT

Aims: To investigate changes in physical activity (PA) and psychological factors during societal lockdown in people with type 2 diabetes. Methods: A cross-sectional study among Dutch adults with type 2 diabetes. Data were collected using online questionnaires. A multivariate multinomial logistic regression was performed with change in PA during societal lockdown as outcome and perceived change in stress, anxiety, perceived risk for COVID-19 infection, emotional well-being and former PA status as determinants. Results: Five hundred and sixty seven respondents filled out the questionnaire, 536 were included in the final analysis: mean age of 65.9 ± 7.9 years; mean diabetes duration 13.3 ± 8 years; 54% men; 47% reported no change in PA, 27% became less active and 26% became more active during societal lockdown. Participants who were more likely to become less active were participants who experienced more stress (OR: 2.27; 95% CI 1.25-4.13) or less stress (OR: 2.20; 95% CI 1.03-4.71). Participants who were more likely to become more active were participants who experienced more stress (OR: 2.31; 95% CI 1.25, 4.26). Participants with higher emotional well-being (OR: 0.98; 95% CI 0.97, 0.99) were less likely to become less active than to report no change in PA. Conclusions: Changes in PA in people with type 2 diabetes during societal lockdown are associated with changes in psychological factors such as perceived stress and emotional well-being. People with diabetes and their caregivers should be aware of these possible changes.


Subject(s)
COVID-19/psychology , Communicable Disease Control , Diabetes Mellitus, Type 2/psychology , Exercise/psychology , Stress, Psychological/psychology , Adult , Aged , COVID-19/prevention & control , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Netherlands
11.
Geriatr Nurs ; 42(1): 57-64, 2021.
Article in English | MEDLINE | ID: covidwho-1172446

ABSTRACT

Type 2 diabetes (T2D) contributes to reduced quality of life in older adults, especially in those with comorbidities such as being overweight or obese. Personal fitness technology (Fitbit ®) has the potential to improve the management of T2D. Using a semi-structured interview guide, focus groups were conducted to explore participants' acceptability and experiences following a behavioral lifestyle intervention that integrated Fitbit in overweight/obese older adults with T2D amid the COVID-19 pandemic which began during the time of this study. Focus group transcripts were transcribed and analyzed using thematic analysis. Eighteen (18) of the 20 participants completed the program and focus group interviews. Overall, we observed high acceptability of the program, and participants reported favorable experiences such as increased knowledge of health behaviors, improved diabetes management, and improved quality of life following the behavioral lifestyle intervention, even under stressful life circumstances from COVID-19.


Subject(s)
Behavior Therapy , COVID-19/epidemiology , Diabetes Mellitus, Type 2/psychology , Fitness Trackers , Life Style , Obesity/psychology , Aged , Diabetes Mellitus, Type 2/complications , Female , Focus Groups , Health Behavior , Humans , Male , Obesity/etiology , Obesity/therapy , Patient Acceptance of Health Care , Patient Satisfaction , Quality of Life
12.
Diabetes Metab Syndr ; 15(3): 733-737, 2021.
Article in English | MEDLINE | ID: covidwho-1163661

ABSTRACT

BACKGROUND AND AIMS: To assess the psychometric properties of the Fear of COVID-19 (FCV-19S) scale and to determine its associated factors among the Pakistani patients with diabetes. METHODS: This observational study was conducted in 24-h helpline service, a department of Baqai Institute of Diabetology and Endocrinology (BIDE). Study duration was from August to September 2020. The target population was registered adult patients with type 2 diabetes aged >16 years. Baseline demographic details were obtained from hospital management system of BIDE. Forward-backward translation method was used to translate the existing Fear scale (FCV-19S). Symptoms of depressive disorder were assessed through Patient Health Questionnaire (PHQ9). RESULTS: Total of 380 participants with mean age 51.93 ± 12.03 years contributed in the study. Three factors loading and item correlation of fear COVID-19 explained 96% of total variance having unidimensional Cronbach's alpha of 0.881. All demographic indicators that showed significance in univariate model were included in multivariate model. Females had more fear for COVID-19 compared to males (OR = 1.73, 95% CI (1.15-2.6)), whereas current smokers had also showed 4 times more fear than non-smokers (OR = 4.19, 95% CI (1.18-14.83). Depression assessed by PHQ9 showed maximum fear of COVID-19 in participants with moderate depression. CONCLUSION: FCV-19S had adequate psychometric properties for assessing effects of pandemic in people with diabetes attending tertiary care center.


Subject(s)
COVID-19/psychology , Depression/etiology , Diabetes Mellitus, Type 2/psychology , Fear , Adult , Aged , Anxiety/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Fear/classification , Fear/psychology , Female , Humans , Male , Middle Aged , Pakistan/epidemiology , Pandemics , Psychometrics/methods , Surveys and Questionnaires , Tertiary Care Centers
14.
Acta Diabetol ; 58(7): 899-909, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1135165

ABSTRACT

AIMS: To assess the impact of teleintervention on mental health parameters in type 2 diabetes patients during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This is a controlled randomized trial for a multidisciplinary telehealth intervention in Southern Brazil, with social distancing measures. Adults aged 18 years or older with previous diagnosis of type 2 diabetes were included in the study. The intervention performed was a set of strategies to help patients stay healthy during the COVID-19 pandemic and included the maintaining of telephone contacts and providing educational materials on issues related to mental health, healthy habits, and diabetes care. The primary outcome was a positive screening for mental health disorders (Self-Reporting Questionnaire) after 16 weeks of intervention. A positive screening for mental health disorders was considered when the survey scored greater than or equal to 7. Secondary outcomes included a positive screening for diabetes-related emotional distress (Problem Areas in Diabetes), eating (Eating Attitudes Test), and sleep disorders (Mini Sleep Questionnaire). Comparisons with χ2 tests for dichotomous outcomes, along with the Mann-Whitney U test, was used for between group analyses. RESULTS: A total of 91 individuals agreed to participate (46 intervention group and 45 control group). There were no differences in demographic and clinical data at baseline. After 16 weeks of follow-up, a positive screening for mental health disorders was found in 37.0% of participants in the intervention group vs. 57.8% in the control group (P = 0.04). Diabetes-related emotional distress was found in 21.7% of participants in the intervention group vs. 42.2% in the control group (P = 0.03). No differences were found between groups with regard to eating and sleep disorders. CONCLUSION: This study demonstrated that maintaining remote connections with health professionals during social distancing and quarantine have the potential to reduce the prevalence of positive screening for mental health disorders and diabetes-related emotional distress in adults with type 2 diabetes.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Diabetes Mellitus, Type 2/therapy , Telemedicine/methods , Adult , Aged , Brazil/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/psychology , Female , Humans , Interdisciplinary Communication , Male , Middle Aged , Pandemics , Patient Care Team/organization & administration , Prevalence , Psychological Distress , Quarantine , SARS-CoV-2/physiology , Self Report , Surveys and Questionnaires , Telemedicine/organization & administration
15.
Diabetes Metab Syndr ; 14(6): 1815-1819, 2020.
Article in English | MEDLINE | ID: covidwho-1059525

ABSTRACT

BACKGROUND AND AIMS: Lockdown during the COVID-19 pandemic imposed many restrictions on the public. Loss of continuum of care along with improper lifestyle was expected to worsen glycemic control in people with type 2 diabetes (T2D). We aimed to identify the effects of lockdown on their glycemic status, lifestyle changes and psychosocial health. METHODS: The pre- and post-lockdown data of 110 adults with T2D who were under regular follow up was collected by direct interview during their visit to the diabetes clinic. The variables analyzed included demographic data, HbA1c, body weight, lifestyle changes, psychosocial factors and use of technology. RESULT: The overall physical activity and dietary adherence remained unchanged in more than 80% of the participants. There was increased consumption of vegetables (80.9%), fruits (42.7%), and decreased unhealthy snacking (63%). 90% of them had access to medications. No significant change was noted in the mean HbA1c and body weight before and after lockdown. Most of them (99%) watched television and 73.6% of them spent time with their family members. Those with mental stress and poor sleep had unhealthy dietary habits. Poor glycemic control was seen in those with less physical activity and an unhealthy diet. CONCLUSION: Lockdown did not cause a major change in the overall glycemic control. Measures to promote healthy lifestyle practices along with ways to reduce psychosocial stress must be implemented for better T2D management during such restricted times.


Subject(s)
COVID-19 , Communicable Disease Control , Diabetes Mellitus, Type 2/therapy , Diet/statistics & numerical data , Exercise , Hypoglycemic Agents/therapeutic use , Mental Health , Stress, Psychological/psychology , Age Factors , Aged , Cross-Sectional Studies , Diabetes Mellitus, Type 2/metabolism , Diabetes Mellitus, Type 2/psychology , Family , Female , Fruit , Glycated Hemoglobin A/metabolism , Health Services Accessibility , Humans , India , Life Style , Male , Middle Aged , SARS-CoV-2 , Sex Factors , Snacks , Surveys and Questionnaires , Television , Vegetables
16.
BMJ Open Diabetes Res Care ; 9(1)2021 01.
Article in English | MEDLINE | ID: covidwho-1021012

ABSTRACT

INTRODUCTION: Lockdown measures have a profound effect on many aspects of daily life relevant for diabetes self-management. We assessed whether lockdown measures, in the context of the COVID-19 pandemic, differentially affect perceived stress, body weight, exercise and related this to glycemic control in people with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS: We performed a short-term observational cohort study at the Leiden University Medical Center. People with type 1 and type 2 diabetes ≥18 years were eligible to participate. Participants filled out online questionnaires, sent in blood for hemoglobin A1c (HbA1c) analysis and shared data of their flash or continuous glucose sensors. HbA1c during the lockdown was compared with the last known HbA1c before the lockdown. RESULTS: In total, 435 people were included (type 1 diabetes n=280, type 2 diabetes n=155). An increase in perceived stress and anxiety, weight gain and less exercise was observed in both groups. There was improvement in glycemic control in the group with the highest HbA1c tertile (type 1 diabetes: -0.39% (-4.3 mmol/mol) (p<0.0001 and type 2 diabetes: -0.62% (-6.8 mmol/mol) (p=0.0036). Perceived stress was associated with difficulty with glycemic control (p<0.0001). CONCLUSIONS: An increase in perceived stress and anxiety, weight gain and less exercise but no deterioration of glycemic control occurs in both people with relatively well-controlled type 1 and type 2 diabetes during short-term lockdown measures. As perceived stress showed to be associated with glycemic control, this provides opportunities for healthcare professionals to put more emphasis on psychological aspects during diabetes care consultations.


Subject(s)
Blood Glucose/metabolism , COVID-19/blood , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 2/blood , Exercise/physiology , Weight Gain/physiology , Adult , Aged , Blood Glucose Self-Monitoring/psychology , Blood Glucose Self-Monitoring/trends , COVID-19/epidemiology , COVID-19/psychology , Cohort Studies , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/psychology , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/psychology , Exercise/psychology , Female , Glycemic Control/psychology , Glycemic Control/trends , Humans , Male , Middle Aged , Outpatient Clinics, Hospital/trends , Sedentary Behavior
17.
Diabet Med ; 38(5): e14498, 2021 05.
Article in English | MEDLINE | ID: covidwho-975494

ABSTRACT

AIM: To describe diabetes nurses' perspectives on the impact of the COVID-19 pandemic on people with diabetes and diabetes services across Europe. METHODS: An online survey developed using a rapid Delphi method. The survey was translated into 17 different languages and disseminated electronically in 27 countries via national diabetes nurse networks. RESULTS: Survey responses from 1829 diabetes nurses were included in the analysis. The responses indicated that 28% (n = 504) and 48% (n = 873) of diabetes nurses felt the COVID-19 pandemic had impacted 'a lot' on the physical and psychological risks of people with diabetes, respectively. The following clinical problems were identified as having increased 'a lot': anxiety 82% (n = 1486); diabetes distress 65% (n = 1189); depression 49% (n = 893); acute hyperglycaemia 39% (n = 710) and foot complications 18% (n = 323). Forty-seven percent (n = 771) of respondents identified that the level of care provided to people with diabetes had declined either extremely or quite severely. Self-management support, diabetes education and psychological support were rated by diabetes nurse respondents as having declined extremely or quite severely during the COVID-19 pandemic by 31% (n = 499), 63% (n = 1,027) and 34% (n = 551), respectively. CONCLUSION: The findings show that diabetes nurses across Europe have seen significant increases in both physical and psychological problems in their patient populations during COVID-19. The data also show that clinical diabetes services have been significantly disrupted. As the COVID-19 situation continues, we need to adapt care systems with some urgency to minimise the impact of the pandemic on the diabetes population.


Subject(s)
COVID-19 , Delivery of Health Care , Diabetes Mellitus/physiopathology , Nurse Specialists , Psychological Distress , Anxiety/psychology , Attitude of Health Personnel , Depression/psychology , Diabetes Mellitus/metabolism , Diabetes Mellitus/nursing , Diabetes Mellitus/psychology , Diabetes Mellitus, Type 1/metabolism , Diabetes Mellitus, Type 1/nursing , Diabetes Mellitus, Type 1/physiopathology , Diabetes Mellitus, Type 1/psychology , Diabetes Mellitus, Type 2/metabolism , Diabetes Mellitus, Type 2/nursing , Diabetes Mellitus, Type 2/physiopathology , Diabetes Mellitus, Type 2/psychology , Diabetic Foot/physiopathology , Europe , Humans , Hyperglycemia/metabolism , SARS-CoV-2 , Self-Management , Surveys and Questionnaires
18.
J Diabetes Complications ; 34(12): 107748, 2020 12.
Article in English | MEDLINE | ID: covidwho-837528

ABSTRACT

AIMS: To describe the effects of the COVID-19 pandemic on adults with T1D or T2D in the U.S. METHODS: Participants, recruited from the Taking Control of Your Diabetes Research Registry, were ≥19 years old and diagnosed with either T1D or T2D for ≥12 months. Participants completed an online survey on a HIPAA-protected platform. RESULTS: Completed surveys were received from 763 T1Ds and 619 T2Ds. Average T1D age was 53.3 (SD = 15.3); average T2D age was 64.9 (SD = 10.3). Both samples were predominantly female, non-Hispanic white and well-educated. Average self-reported HbA1c was 6.9 (SD = 1.0; 52 mmol/mol) for T1Ds and 7.1 (SD = 1.1; 54 mmol/mol) for T2Ds. About 40% of respondents reported that all of their diabetes healthcare appointments at the time were cancelled or postponed, 40% reported a switch to telehealth appointments and almost half reported lower overall satisfaction with these visits (compared to pre-pandemic). There were widespread increases in general and diabetes-related stress and social isolation, and negative effects on disease management. About 25% reported increases in highs, lows, and glucose variability in both groups. CONCLUSION: There has been a substantive increase in level of diabetes-related and general life stress and social isolation due to the pandemic, with a significant impact on disease management.


Subject(s)
COVID-19/psychology , Diabetes Mellitus, Type 1/psychology , Diabetes Mellitus, Type 1/therapy , Diabetes Mellitus, Type 2/psychology , Diabetes Mellitus, Type 2/therapy , SARS-CoV-2 , Adult , Aged , Cohort Studies , Delivery of Health Care/statistics & numerical data , Female , Glycated Hemoglobin A/analysis , Health Services Accessibility/statistics & numerical data , Humans , Male , Middle Aged , Social Isolation/psychology , Stress, Psychological/epidemiology , Surveys and Questionnaires , Telemedicine
19.
Diabetes Technol Ther ; 22(7): 527-534, 2020 07.
Article in English | MEDLINE | ID: covidwho-629085

ABSTRACT

Aim: To evaluate the effects of a prolonged lockdown due to Coronavirus (COVID-19) on the adoption of newer technologies and changes in glycemic control on patients with type 2 diabetes (T2D) in India. Methods: The study population included a random list of 3000 individuals with T2D derived from 30,748 individuals who had visited a large tertiary diabetes center during the past year. The survey was carried out through a telephonic interview. A structured questionnaire was used to collect information on changes in lifestyle, access and challenges to diabetes care and use of technologies such as telemedicine facilities and use of self-monitoring of blood glucose (SMBG), etc. Results: Of the 2510 individuals successfully interviewed (83.7% response rate), 382 (15.2%) reported having attempted to consult their health care providers during the lockdown, of whom only 30.6% utilized the telemedicine facility. However, 96 (82%) of those who utilized the telemedicine facility (n = 117) were happy with their experience and 68 (58.1%) were willing to continue to use the facility in the future. Only 11.4% of participants utilized online support for management of diabetes. Use of SMBG increased significantly from 15.5% to 51.3% during the lockdown. There was an improvement in glycemic control during the lockdown (HbA1c:before vs. during lockdown: 8.2% ± 1.9% vs. 7.7% ± 1.7%, P < 0.001) in a nonrandomly selected subset of subjects (n = 205). Conclusions: Acceptance of telemedicine facilities remains suboptimal in this Asian Indian population, in spite of high levels of satisfaction among those who utilized it. The COVID-19 pandemic and the subsequent lockdown have not adversely affected metabolic control in our patients, and indeed there appears to be an improvement in HbA1c levels. Greater accessibility and acceptance of technology could help individuals with diabetes to maintain better contact with their physicians and ensure better metabolic control in the future.


Subject(s)
Coronavirus Infections/prevention & control , Diabetes Mellitus, Type 2/therapy , Pandemics/prevention & control , Patient Acceptance of Health Care/statistics & numerical data , Pneumonia, Viral/prevention & control , Quarantine/statistics & numerical data , Telemedicine/statistics & numerical data , Adult , Betacoronavirus , Blood Glucose/analysis , Blood Glucose Self-Monitoring/statistics & numerical data , COVID-19 , Cross-Sectional Studies , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/psychology , Female , Humans , India/epidemiology , Male , Middle Aged , Patient Satisfaction/statistics & numerical data , Quarantine/psychology , SARS-CoV-2 , Telemedicine/methods
20.
Diabetes Metab Syndr ; 14(5): 1583-1587, 2020.
Article in English | MEDLINE | ID: covidwho-709517

ABSTRACT

AIMS: To explore the impact of the coronavirus disease lockdown on diabetes patients living in Jeddah, Saudi Arabia, in terms of their compliance with medication intake and lifestyle habits, and quality of life. METHODS: In this cross-sectional, qualitative prospective study, a questionnaire was administered over the telephone to diabetes patients who had attended National Guard primary care centers in Jeddah, Saudi Arabia. The survey included questions on demographic data, type of diabetes, medications used, comorbidities, medication compliance, and daily habits before and after the lockdown, and those assessing patients' psychological parameters during the past month by using the Kessler Psychological Distress Scale (K10). Data analysis was performed using SPSS program version 26. RESULTS: Totally, 394 patients participated. All of them had type 2 diabetes, and 37.6% had only one comorbidity. Antidiabetic monotherapy was used in 76.4% of the patients, while combination therapy was used in 23.6%. The compliance score before the lockdown was significantly higher (18.49 ± 3.05) than that after it (17.40 ± 3.25) (p-value <0.001). The average psychological assessment score was 9.78 ± 4.14 (range 8-35). Male participants and smokers had a significantly better psychological status than female participants (p-value = 0.002) and non-smokers (p value < 0.001), respectively. CONCLUSIONS: The patients' levels of compliance with medications and healthy lifestyle habits were significantly reduced after the lockdown. These findings highlight the need for healthcare professionals to encourage diabetes patients to adhere to healthy lifestyle habits and use telemedicine during lockdowns to ensure optimal blood glucose control and reduce the incidence of complications.


Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/therapeutic use , Medication Adherence/statistics & numerical data , Quarantine/psychology , Adult , COVID-19 , Coronavirus Infections , Cross-Sectional Studies , Diabetes Mellitus, Type 2/psychology , Female , Humans , Life Style , Male , Middle Aged , Pandemics , Pneumonia, Viral , Prospective Studies , Qualitative Research , Quality of Life , Saudi Arabia , Young Adult
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