Psychosocial Problems in Indonesian Children and Adolescents with Type 1 Diabetes (T1D) during COVID-Pandemic

ABSTRACT

Objectives: The COVID-pandemic has presented challenges for individuals with chronic diseases in resource-limited settings. Lockdowns and restrictions have decreased access to health care and disrupted medical support. Those challenges might affect the psychological status of children and adolescents with T1D. Methods: The study was conducted with ethics approval in the Endocrinology Clinic Cipto Mangunkusumo Hospital, Jakarta, Indonesia June 2020-June 2021. Demographic background, COVID-knowledge, challenges and psychosocial problems were assesed using a questionnaire. Surveys were given in person and online. Results: There were 148 respondents (23 adolescents, 1parents, 14 relatives) . Median age was 13 (3-18) , 51% female. During the pandemic, median A1C was 8.2% and complications that occurred were frequent hyperglycemia (23%) , hypoglycemia (14%) , and ketoacidosis (8%) . Most patients used national health insurance (90%) in public hospital (80%) . Most of the respondents reported being affected by lockdowns in their area (73%) , although many could still visit healthcare facilities (44%) . Despite getting exemption for healthcare visit in lockdown period, about almost half of them felt that their check-up routines were disrupted (41%) mainly due to fear of getting infected with COVID-during visit (34%) . Many children had some psychological problem (51%) such as irritability (26%) , distress (12%) , anxiety (11%) and insomnia (10%) . As many as 37% of them needed psychological support from either health care workers or their relatives. Conclusions: The COVID-pandemic has presented new challenges for diabetes management in children and adolescents living in resource-limited settings. Patients' routine visits, access to essential diabetes care and psychological states have been affected. Given the ongoing nature of waves during the pandemic, further studies about the impact of COVID-pandemic on psychological well-being are needed.