Impact of COVID-19 Pandemic on Daily Life, Physical Exercise, and General Health among Older People with Type 2 Diabetes: A Qualitative Interview Study

Abstract

The COVID-19 pandemic has resulted in significant alterations to and implications for the lives of millions of people, and especially for those with pre-existing medical conditions. The aim of this study was to explore the lived experience of older people with type 2 diabetes mellitus (T2DM) throughout the first 9 months of the pandemic, with emphasis on the habits of physical exercise. We conducted a qualitative study using semi-structured interviews. The data consist of telephone interviews of seventeen older people with T2DM (10 women and 7 men, aged 62–76 years). Using thematic analysis, five themes were generated: (1) an altered social and relational life; (2) changes in routine and attitude regarding physical activity behaviour; (3) home-related activities gained relevance; (4) health and well-being impact and management; and (5) thoughts about the post-pandemic period. The increase in the number of cases and the fear of becoming infected with COVID-19 limited the social (i.e., contact with family and/or friends) and functional (i.e., daily routine, the habit of exercising) lives of these people, reverberating negatively on their health and well-being. Feelings of isolation, loneliness, anxiety were common. The findings of this study help to better understand the impact of the pandemic and determine areas of need for future interventions. A multidisciplinary approach is necessary to provide support for older people with T2DM and tackle the negative effect of the pandemic, including the reduction in physical activity.

The indirect impact of the COVID-19 pandemic on people with type 2 diabetes mellitus and without COVID-19 infection: Systematic review and meta-analysis

“…Disruption of healthcare is a widely discussed impact of the pandemic. A universally decreased health service utilization for non-COVID-19 conditions [56] has been reported in many countries [4] , [12] , [57] , [58] , characterized by reduced health service hours due to lockdowns, dwindling human resource availability due to medical source re-allocation, and hesitancy to seek care due to fears of contracting the virus during the pandemic; such change may result in challenging management of diabetes in the long term, even though it takes time to be revealed. One study [59] examined the impact of the 2003 SARS epidemic retrospectively and found a short-term dramatic decline in healthcare utilization would lead to increased diabetic mortality one year after the outbreak [relative risk:1.08 (CI: 1.03 – 1.15)].…”

“…A large proportion of health resources were reallocated to COVID-19 or emergency care [11] . People were reluctant to seek medical assistance due to fear of risking exposure to the infection [4] , [12] , [13] . For people with T2DM who require consistent monitoring of symptoms and timely treatment adjustment, such as personalized glycemic control protocol [14] , the disruption of care created new barriers to managing the disease, which may have resulted in poor health outcomes or incidence of diabetes-related complications.…”

Prevalence of loneliness and associations with health behaviours and body mass index in 5835 people living with and beyond cancer: a cross-sectional study

“…Future research should employ qualitative methods to uncover the nuances in these associations and to explore potential mechanisms. For example, qualitative interviews with a sample of people with type 2 diabetes revealed reduced motivation due to loneliness and reduced social contact inhibited engagement in physical activity during the COVID-19 pandemic [ 97 ].…”

Loneliness, depression and sleep quality among the type 2 diabetic patients during COVID‐19 local epidemic: A mediation analysis

“…With the normalized management of the epidemic, more attention has been paid to the loneliness of T2DM patients. The epidemic has increased the difficulty of disease management, which is no different from making things worse for diabetics (Leite et al, 2022).…”