The impact of COVID-19 on diabetes management for adolescents with T1D and their parents

ABSTRACT

Introduction: For families with type 1 diabetes (T1D), anxiety from the COVID-19 pandemic may be elevated due to potential for increased vulnerability. Objectives: We aimed to describe the impact of the pandemic on adolescents with T1D and their parents. Methods: In a 2-site (Seattle WA, Houston TX USA) clinical trial of a psychosocial intervention targeting stress/resilience, adolescents 13-18 years old with T1D ≥ 1 year and diabetes distress (PAID-T ≥30) were enrolled with a parent. Using a mixed-methods approach, participants enrolled August 2020-June 2021 completed a survey about the pandemic, including an open-ended question about how COVID impacted T1D management. Survey responses were summarized using frequencies and percentages, and associations between variables were assessed by Chi-squared tests. A1C was extracted from clinical records. Results: Adolescents (n=122) were 56% female, 80% White race, 18% Hispanic, mean A1c = 8.5±2.1%. Parents (n=102) were 79% White, 14% Hispanic, 61% college graduate, 67% reporting annual household income ≥75K USD. 10% of adolescents reported history of COVID-19 infection, 51% had a family member/other important person diagnosed, and 12% had a family member/other important person die from COVID-19 complications. 49% of parents reported loss of job or salary reduction. 29% of adolescents and 33% of parents reported significant struggle to manage T1D during the pandemic (Table 1). Adolescents who reported more difficulty with T1D management were more likely to have A1C ≥ 8%, p<.01. Qualitative themes indicated perceived positive, negative, and neutral effects of the pandemic on T1D self-care, exercise, food, mental health, telehealth, and motivation. Conclusions: Discussing how the pandemic impacted families' T1D management may be an important focus for clinicians, especially for adolescents with above-target A1C. Strategies to improve resilience for ongoing and future stress may be of value. (Table Presented).