Perceptions and Correlates of Distress Due to the COVID-19 Pandemic and Stress Management Strategies Among Adults With Diabetes: A Mixed-Methods Study

Im, James; Escudero, Carlos; Zhang, Kendra; Choi, Dorothy; Sivakumar, Arani; Booth, Gillian L.; Sale, Joanna; Pritlove, Cheryl; Advani, Andrew; Yu, Catherine

doi:10.1016/j.jcjd.2021.10.006

Cited by 8 publications

(6 citation statements)

References 42 publications

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“…Thus, in Ontario rtCGM is primarily used by emerging adults with type 1 diabetes who have private health insurance or else the financial means to pay for the device independently. This illustrates a recurring theme that has emerged during the COVID-19 pandemic, that those of higher socioeconomic status achieved better outcomes [ 8 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Sustained Improvement in Glycemic Control in Emerging Adults with Type 1 Diabetes 2 Years After the Start of the COVID-19 Pandemic

Swaich

Advani

2022

Diabetes Ther

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Introduction Although there were initial concerns that the public health response to the COVID-19 pandemic would adversely affect glycemic control in people with type 1 diabetes, several early continuous glucose monitor (CGM) studies reported an unexpected slight improvement in glucose metrics. Early emerging adulthood (roughly spanning the ages of 18–24 years) is often a vulnerable time in the life of a person with type 1 diabetes. Here, we set out to determine how the care and glucose management of emerging adults with type 1 diabetes changed over a period of approximately 2 years from the start of the COVID-19 pandemic. Methods This was a retrospective study of a tertiary referral, multidisciplinary young adult diabetes clinic, spanning before and after the 777-day state of emergency in the City of Toronto. Results Of 130 emerging adults with type 1 diabetes (80 male, 50 female; mean age 21.0 ± 2.1 years), baseline pre-pandemic HbA 1c values were available for 120 individuals. During 24.9 ± 5.4 months of follow-up before and after the start of the COVID-19 pandemic, HbA 1c fell from 8.5 ± 1.7% (69.3 ± 18.8 mmol/mol) to 8.1 ± 1.9% (65.2 ± 20.5 mmol/mol) ( P < 0.05), with change in HbA 1c from pre-lockdown levels being sustained throughout the second year of the pandemic. Over the same period, CGM use rose from 43% to 83%, primarily through increased uptake of intermittently scanned CGM, which is covered through the Ontario Drug Benefit program. Change in HbA 1c was most evident in Dexcom G6 real-time CGM users − 0.7 ± 1.2% (− 9.8 ± 17.1 mmol/mol) ( P < 0.01 vs. self-monitoring of blood glucose). Conclusion Among emerging adults with type 1 diabetes attending a multidisciplinary clinic in a high-income country, glycated hemoglobin levels are on average 0.4% (4.1 mmol/mol) lower than they were before the pandemic. This reduction in HbA 1c is unlikely to be a consequence of early strict lockdowns given the length of time of follow-up. Rather, improved glycemic control coincided with increased utilization of wearable diabetes devices.

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Section: Discussionmentioning

confidence: 99%

Sustained Improvement in Glycemic Control in Emerging Adults with Type 1 Diabetes 2 Years After the Start of the COVID-19 Pandemic

Swaich

Advani

2022

Diabetes Ther

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“…Participants with higher DD were generally less satisfied with their financial status, partly because those with lower income were less able to maintain appropriate glycemic control strategies and manage the stress caused by diabetes. 28 Therefore, we need to develop cost-effective diabetes management, supportive interventions, and financial incentives to improve diabetes care. Other demographic characteristics were not correlated with the DD scores in this study.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Correlators of Diabetes Distress in Adults with Type 2 Diabetes: A Cross-Sectional Study

Zhang,

Li,

Sheng

et al. 2024

PPA

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Purpose To address the prevalence of diabetes distress (DD) and its correlators in adults with type 2 diabetes. Patients and Methods During 2021 and 2022, we conducted a cross-sectional study in three Class A tertiary comprehensive hospitals in China, and received 947 participants who completed a printed survey covering DD, demographic, diabetic, physiological, and psychosocial factors. We used Jonckheere-Terpstra, chi-square, and Fisher’s exact tests to assess intergroup differences between different levels of DD. We used ordinal logistic regression analysis to analyze correlators of DD further. Results The prevalence of DD was 34.64%. In univariate analysis, those with lower satisfaction with financial status, longer durations of diabetes, more complications, higher glycemia, more severe insomnia, treatment by medications only, poorer lifestyle interventions, fewer self-care activities, more types and frequencies of insulin injections, and spending more money and time on treatment were susceptible to DD. Type D personality, negative illness perceptions, negative coping styles, and psychological effects of major life events were related to higher DD. Hope, self-efficacy, positive coping styles, and social support can reduce DD. In ordinal logistic regression analysis, hypoglycemic episode ( β =−1.118, p =0.019, “have hypoglycemic” as reference) and Brief Illness Perception Questionnaire ( β =0.090, p <0.001) were significant positive correlators for DD, while diet intervention ( β =0.803, p =0.022, “have diet intervention” as reference), money spent on diabetes treatment ( β <-0.001, p =0.035), and SES ( β =−0.257, p <0.001) were significant negative correlators. Conclusion More than one-third of Chinese adults with type 2 diabetes experience moderate or high levels of DD. DD was associated with financial, diabetic, physiological, and psychosocial status.

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“…In the last two decades, numerous scales were developed to measure resilience levels in different contexts for a specific population, intervention, or outcomes based on different components [ 45 ]. The Brief Resilience Coping Scale (BRCS) has been applied to different samples, including the general population [ 46 , 47 ], family caregivers [ 48 , 49 ], and persons living with chronic diseases [ 18 , 19 , 50 , 51 ]. The lack of published studies on resilience in rare diseases [ 15 ] emphasizes the significant gap in research.…”

Section: Introductionmentioning

confidence: 99%

Resilience in patients and family caregivers living with congenital disorders of glycosylation (CDG): a quantitative study using the brief resilience coping scale (BRCS)

Poejo,

Gomes,

Granjo

et al. 2024

Orphanet J Rare Dis

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Background Patients and family caregivers living with Congenital Disorders of Glycosylation (CDG) experience a heavy burden, which can impact their resiliency and quality of life. The study’s purpose was to measure the resilience levels of patients and family caregivers living with CDG using the brief resilience coping scale. Methods We conducted an observational, cross-sectional study with 23 patients and 151 family caregivers living with CDG. Descriptive analyses were performed to characterize patients with CDG and family caregivers’ samples. Additionally, we assessed correlations between resilience and specific variables (e.g., age, academic degree, time until diagnosis) and examined resilience differences between groups (e.g., sex, marital status, occupation, professional and social support). Results GNE myopathy was the most prevalent CDG among patients, while in family caregivers was PMM2-CDG. Both samples showed medium levels of resilience coping scores. Individuals with GNE myopathy had significantly higher scores of resilience compared to patients with other CDG. Resilience was positively correlated with educational degree in patients with CDG. Family caregivers had marginally significant higher scores of resilience coping if they received any kind of professional support or had contact with other families or people with the same or similar disease, compared with unsupported individuals. Conclusions Despite the inherited difficulties of living with a life-threatening disease like CDG, patients and family caregivers showed medium resilient coping levels. Resilience scores changed significantly considering the CDG genotype, individual's academic degree and professional and social support. These exploratory findings can empower the healthcare system and private institutions by promoting the development of targeted interventions to enhance individuals` coping skills and improve the overall well-being and mental health of the CDG community.

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Perceptions and Correlates of Distress Due to the COVID-19 Pandemic and Stress Management Strategies Among Adults With Diabetes: A Mixed-Methods Study

Cited by 8 publications

References 42 publications

Sustained Improvement in Glycemic Control in Emerging Adults with Type 1 Diabetes 2 Years After the Start of the COVID-19 Pandemic

Sustained Improvement in Glycemic Control in Emerging Adults with Type 1 Diabetes 2 Years After the Start of the COVID-19 Pandemic

Prevalence and Correlators of Diabetes Distress in Adults with Type 2 Diabetes: A Cross-Sectional Study

Resilience in patients and family caregivers living with congenital disorders of glycosylation (CDG): a quantitative study using the brief resilience coping scale (BRCS)

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