Perceived Stress Among Indian Children And Young Adults Living With Type 1 Diabetes During the COVID-19 Outbreak

Abstract

Background - 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- To evaluate perceived stress towards COVID-19 among T1D individuals.Study Design - A cross-sectional, observational study. Participants - Adolescents and young adults (aged 10 - 25), living with T1D; and age, gender matched controls.Interventions - An online, semi-structured survey including Perceived Stress Scale. Outcomes - Determinants of stress and its impact on glycemic control.Results - A total of 97 cases (49 males; mean age 18.8 ± 4.5 years), diagnosed with T1D (mean diabetes duration 8.0 ± 5.0 years; mean HBA1C 8.1 ± 1.5%) completed the survey. Among cases, 53.6% reported moderate stress; 41.2% low stress and 5.2% severe stress. No significant difference was observed in the mean PSS score between the cases and controls. Cases with higher PSS scores tracked pandemic-related updates with significantly lesser frequency than those with lower scores (mean rank 78.75; p = 0.01). High PSS score was significantly associated with HbA1C over last 6 months (r 0.276; p = 0.015) and worsened glycemic control (mean rank 63.97 p = 0.012). Conclusion- An increased apprehension was seen regarding the acquisition of optimal diabetes management and care during the current infectious outbreak. Tele-medicine could emerge as an effective tool and a promising initiative to manage T1D patients during the pandemic.

COVID‐19 related anxiety in children and adolescents with severe obesity: A mixed‐methods study

“…To our knowledge, this is the first study to investigate COVID‐19 related anxiety in children and adolescents with obesity, and only few studies explored similar psychological effects in children with other chronic diseases. A recent study in children with type 1 diabetes in India reported that moderate or severe stress was present in nearly 60% of their patients during the COVID‐19 pandemic, but this did not differ from age‐ and gender‐matched controls 20 . Another study in children with cystic fibrosis in Turkey also did not find a difference in anxiety scores between their patients and age‐matched controls 21 .…”

Psychological adaptive difficulties and their management during COVID-19 pandemic in people with diabetes mellitus

“…An online-based survey reported that only one-fourth of the participants (28%) were regularly monitoring their blood glucose during the COVID - 19 lockdown and two-fifth of participants (40%) were anxious about COVID-19 infection [ 26 ]. More than half of the participants with diabetes are worried about the greater risk of developing COVID-19 and about one-third are concerned about difficulties in managing their diabetes if they contract COVID-19 [ 22 , 27 ].Being female, feeling isolated and lonely and having type 1 DM, DD, and complications related to diabetes were the predictors for a greater worry and loneliness compared to the general population [ 26 ]. Another study reported moderate to severe stress in more than half of the respondents with type 1 diabetes during the COVID-19 pandemic and main concerns were related to glycemic control and availability of appropriate care [ 27 ].…”

Short-Term Effects of COVID-19 Lockdown in Italian Children and Adolescents with Type 1 Diabetes Mellitus: The Role of Separation Anxiety

“…Regarding the relationship between psychological well-being and metabolic control, research shows that higher stress was reported by those with higher glycated hemoglobin (HbA1c) levels over the preceding 6 months. Moreover, a bidirectional relationship between stress and glycemic control has been hypothesized [ 13 ]. Contrasting data on the glycemic control of adults with diabetes during the pandemic are available.…”