Anxiety, depression, and glycemic control during Covid-19 pandemic in youths with type 1 diabetes

Abstract

Objectives Our study aims to assess the impact of lockdown during the coronavirus disease 2019 pandemic on glycemic control and psychological well-being in youths with type 1 diabetes. Methods We compared glycemic metrics during lockdown with the same period of 2019. The psychological impact was evaluated with the Test of Anxiety and Depression. Results We analyzed metrics of 117 adolescents (87% on Multiple Daily Injections and 100% were flash glucose monitoring/continuous glucose monitoring users). During the lockdown, we observed an increase of the percentage of time in range (TIR) (p<0.001), with a significant reduction of time in moderate (p=0.002), and severe hypoglycemia (p=0.001), as well as the percentage of time in hyperglycemia (p<0.001). Glucose variability did not differ (p=0.863). The glucose management indicator was lower (p=0.001). 7% of youths reached the threshold-score (≥115) for anxiety and 16% for depression. A higher score was associated with lower TIR [p=0.028, p=0.012]. Conclusions Glycemic control improved during the first lockdown period with respect to the previous year. Symptoms of depression and anxiety were associated with worse glycemic control; future researches are necessary to establish if this improvement is transient and if psychological difficulties will increase during the prolonged pandemic situation.

Impact of COVID-19 restrictions on diabetes health checks and prescribing for people with type 2 diabetes: a UK-wide cohort study involving 618 161 people in primary care

“…Some studies in insulin-treated people Original research have suggested improvements in glucose control perhaps brought about through more regular mealtimes, increased consumption of homemade foods, decreased workloads, less exercise and more time for self-care. [24][25][26] However, in many people with T2D, there is evidence that national lockdowns have had detrimental effects on CVD risk, which could be exacerbated by the reduced monitoring and prescribing observed in our study. In surveys of UK adults conducted during the first lockdown (April--May 2020), participants reported adverse changes in several behaviours that promote weight gain (adverse changes in diet, physical activity, alcohol consumption, mental health and sleep quality).…”

Prevalence of Depression and Related Factors among Patients with Chronic Disease during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

“…The clinical predictors of diabetes found to be related to higher levels of depression included high HbA1c [ 38 , 39 , 43 , 44 ], low daily time-in-range blood glucose [ 38 , 45 ], type 2 diabetes [ 27 , 32 ], and diabetes duration of >5 years [ 38 ]. According to Chao et al (2021), obesity was a predisposing factor for depression, but Alaqeel et al (2021) obtained no significant results in this respect ( Table 2 ).…”

Psychosocial Impact of the COVID-19 Pandemic in Racially/Ethnically Diverse Youth With Diabetes

“…The impact of COVID-19 on glycemic health in pediatric diabetes is unclear. One study suggested that blood glucose levels had lowered in children with T1D during the COVID-19 pandemic ( Cusinato et al, 2021 ), while other studies showed no change ( Danne et al, 2021 ; Nwosu et al, 2021 ). A small study in an underserved population in Baltimore showed increased average HbA1c levels in youth with T2D during the COVID-19 pandemic ( Bharill et al, 2021 ).…”

“…A small study in an underserved population in Baltimore showed increased average HbA1c levels in youth with T2D during the COVID-19 pandemic ( Bharill et al, 2021 ). The complexity is highlighted by a study in youth with T1D showing that while average blood glucose levels were reduced during “lockdown,” high levels of anxiety and depression were reported and linked to reduced time-in-range on continuous glucose monitoring ( Cusinato et al, 2021 ). Therefore, it is important to consider how the COVID-19 pandemic’s impact on glycemic health may vary across families based on their experience of stressors related to the pandemic.…”