Psychological stress and worsening diabetes: An endemic within the pandemic!

ABSTRACT

Introduction: Strict isolation measures and interrupted healthcare services during the COVID-19 pandemic are contemplated to instigate stress universally, particularly in those with chronic illnesses such as Type 1 Diabetes (T1D). Objective(s) To evaluate the determinants of stress and its impact on glycemic control among Indian adolescents and young adults (aged 10-25 years), living with T1D. Method(s) A cross-sectional observational study using online, semistructured survey, including Perceived Stress Scale (PSS-10). Result(s) A total of 97 patients (49 males;mean age 18.8 +/- 4.5 years, mean diabetes duration 8.0 +/- 5.0 years;mean HbA1c 8.1 +/- 1.5%) were analyzed. Age (y) (r = 0.325, p = 0.005) and HbA1c (%) within the preceding 3 months (r = 0.274, p = 0.036) correlated positively with PSS-10 score, Figure 1. There was a statistically significant difference in PSS-10 score based on gender (t [70] = -2.147;p = 0.035), education (F [4,67] = 4.34, p = 0.003) and occupation (F [3,68] = 4.50, p = 0.006). On multiple linear regression, gender, occupation and HbA1c were the significant determinants of PSS-10 (F [3,55] =12.01, p < 0.001, R2 = 0.363). One-way ANOVA showed a significant impact of mean PSS-10 score on the glycemic control (F [2,69] = 3.813, p = 0.027). Conclusion(s) Female gender, salaried individuals, and pre-existing poorly controlled diabetes contributed to an increased risk of stress. Increased stress resulted in worsened glycemic control.