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Cross-national comparison of psychosocial well-being and diabetes outcomes in adults with type 1 diabetes during the COVID-19 pandemic in US, Brazil, and Iran.
Abdoli, Samereh; Silveira, Monica S V M; Doosti-Irani, Mehri; Fanti, Paulo; Miller-Bains, Katherine; Pavin, Elizabeth João; Cardoso, Edimariz Buin; Vardanjani, Leila Rafiee; Noorian, Kobra; Hessler, Danielle.
  • Abdoli S; College of Nursing, University of Tennessee, 1200 Volunteer Blvd Rm 155, Knoxville, TN, 37996, USA. sabdoli@utk.edu.
  • Silveira MSVM; Faculty of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, São Paulo, 13083-887, Brazil.
  • Doosti-Irani M; School of Nursing and Midwifery, Shahrekourd University of Medical Sciences, Shahrekord, Iran.
  • Fanti P; Faculty of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, São Paulo, 13083-887, Brazil.
  • Miller-Bains K; Assessment and Evaluation, Oak Ridge Associated Universities, Oak Ridge, TN, 37831, USA.
  • Pavin EJ; Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, São Paulo, 13083-887, Brazil.
  • Cardoso EB; Clinical Psychologist, Faculty of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, São Paulo, 13083-887, Brazil.
  • Vardanjani LR; School of Nursing and Midwifery, Shahrekourd University of Medical Sciences, Shahrekord, Iran.
  • Noorian K; School of Nursing and Midwifery, Shahrekourd University of Medical Sciences, Shahrekord, Iran.
  • Hessler D; Department of Family and Community Medicine, University of California, 500 Parnassus Avenue, San Francisco, CA, 94117, USA.
Diabetol Metab Syndr ; 13(1): 63, 2021 Jun 11.
Article in English | MEDLINE | ID: covidwho-1266502
ABSTRACT

BACKGROUND:

The COVID-19 pandemic is a global public health emergency, which presents wide-ranging negative impacts on individuals with diabetes. To examine psychosocial well-being and diabetes outcomes in individuals with type 1 diabetes during the COVID-19 pandemic, and investigate how these factors vary in different countries.

METHODS:

Between April and June 2020 we employed a cross national comparative research study in the United States (US), Brazil, and Iran to collect data from 1788 adults with type 1 diabetes using web-based survey. Study participants answered questions relevant to diabetes distress, diabetes burnout, depressive symptoms, COVID-19 related changes, and socio-demographic characteristics. They also reported their last Hemoglobin A1c (HbA1c) and daily Time-in-Range (TiR) blood glucose. We analyzed data using comparative tests (Chi-square, Kruskal-Wallis and McNemar test), logistic and linear regression adjusted for fixed effects.

RESULTS:

There were significant changes prior and during the pandemic regarding access to diabetes care, diabetes supplies and medications, healthy food and safe places to exercise in all countries (p < 0.05). Participants in Iran experienced higher levels of diabetes distress (57.1%), diabetes burnout (50%), and depressive symptoms (60.9%), followed by Brazil and US (p < 0.0001). US participants reported better glycemic control (HbA1c = 6.97%, T1R = 69.64%) compared to Brazil (HbA1c = 7.94%, T1R = 51.95%) and Iran (HbA1c = 7.47%, T1R = 51.53%) (p < 0.0001). There were also significant relationships between psychosocial well-being, diabetes outcomes, socio-demographic data, and COVID-19 related challenges in overall sample (p < 0.05).

CONCLUSIONS:

Regardless of differences among US, Brazil, and Iran, our findings revealed that different countries may experience similar challenges related to the COVID-19 pandemic which can impact negatively diabetes outcomes and psychosocial well-being in individuals with type 1 diabetes. Countries need to consider modifiable variables associated with poor diabetes outcomes and sub optimal psychosocial well-being and target vulnerable population using significant socio-demographic variables.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Randomized controlled trials Country/Region as subject: South America / Brazil Language: English Journal: Diabetol Metab Syndr Year: 2021 Document Type: Article Affiliation country: S13098-021-00681-0

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Randomized controlled trials Country/Region as subject: South America / Brazil Language: English Journal: Diabetol Metab Syndr Year: 2021 Document Type: Article Affiliation country: S13098-021-00681-0