COVID-19 Pandemic Upped Anxiety in Adults, Kids With Diabetes

The COVID-19 pandemic had negative psychosocial consequences for adults and children with diabetes, according to two studies.

In a survey conducted in October 2020, one in five adults with diabetes reported anxiety (20.2%) 0r depression (21.2%) at levels spanning from moderate to severe. In addition, 47% of adults with type 1 diabetes reported moderate-to-severe distress compared with only 11% of adults with type 2 diabetes, who reported a "positive score" on the distress scale (P<0.05), reported Sarah C. Westen, PhD, of the the University of Florida in Gainesville, at the virtual American Diabetes Association (ADA) Scientific Sessions.

The pandemic yielded a "neutral" effect on participants' mood overall (mean Likert Scale score 3.27), according to a COVID impact measure that the team adopted for this study.

Patients reporting negative psychosocial impacts need follow-up care, Westen told MedPage Today. "Providers need to be screening and talking to patients about how COVID could be affecting them."

"Listening to a patient and family's lived experience is really the critical component," she said during her presentation.

In addition to the October survey, the researchers conducted follow-up surveys 3 and 6 months later, and are in the process of analyzing that data, using SPSS software.

The study included 193 adults (57% women) from University of Florida Health; 81.9% were white -- "so that's a limitation," Westen acknowledged. Of the participants, 68.4% had type 2 diabetes, while 31.1% had type 1.

The researchers used the General Anxiety Disorder-7 to measure anxiety, the eight-item Patient Health Questionnaire to measure depression, and the Diabetes Distress Scale to measure distress.

"We do need longitudinal research to better understand" how the psychosocial variables interacted with diabetes and the pandemic, Westen said.

In another survey study, presented in a poster at the ADA meeting, Karen Dimentstein, MPH, of Nova Southeastern University in Fort Lauderdale, Florida, and colleagues examined the psychosocial consequences of diabetes management among pediatric patients with type 1 diabetes and their families during the COVID pandemic.

"Common themes regarding the impact of COVID-19 were increased health anxiety, limited social interaction, and routine disruption," the authors noted in their presentation.

The COVID-19 Exposure and Family Impact Survey (CEFIS) was administered to families with children with type 1 diabetes at two comprehensive clinics in Baltimore and Fort Lauderdale. Items were scored and analyzed using SPSS, and themes were coded for open-ended questions.

The analysis included 99 children. Mean age was 12.2 years. The majority were non-Hispanic white (54.1%); 25.5% were Black and 15.3% were Hispanic.

On a scale of 1-4, the CEFIS composite mean score for impact of the pandemic on psychosocial elements was 2.6. On a 1-10 scale, the mean score for effect on family distress was 5.4, and was 5.8 for effect on caregiver distress.

In the survey's open-ended questions, one respondent wrote, "Routine was upended and negatively impacted her mental health, disordered eating, education is truly suffering, and her anxiety is at a high."

Another noted that the pandemic allowed her to monitor the child's diabetes, "with both parents fortunate to telework." However, one respondent said the pandemic "made it more difficult to manage her diabetes."

"Risk and protective factors should be examined to assess and intervene with caregivers of youth with diabetes," the researchers said.

"It may be helpful to consider individual factors for families, and how we can assess these factors clinically and determine their impact on overall glycemic control and quality of life," they added.

Study limitations included the survey's reliance on caregivers, who may have underreported child distress.