Self-Regulation as a Protective Factor for Diabetes Distress and Adherence in Youth with Type 1 Diabetes During the COVID-19 Pandemic

Abstract

Objective The COVID-19 pandemic increased economic, social, and health stressors for families, yet its impacts on families of youth with chronic conditions, such as type 1 diabetes (T1D), are not well understood. Self-regulation (SR)—or the capacities to control emotions, cognition, and behavior in response to challenge—is known to support T1D management and coping in the face of stress. Strong SR may have protected youth with T1D from the impacts of pandemic-related stressors. This study compared youth and parent emotional functioning and T1D management before and after the pandemic’s onset in relation to family pandemic-related stress and youth SR. Methods Parents of youth with T1D (N = 88) and a subset of these youth (N = 43; Mean age 15.3 years [SD 2.2]) completed surveys regarding SR, stress, emotional functioning, and T1D-related functioning prior to and after March 2020. Outcomes were compared using mixed effects models adjusting for covariates. Family pandemic-related stress experiences and youth SR were tested as moderators of change. Results Parents’ responsibility for T1D management increased across pandemic onset and their diabetes-related distress decreased. Family pandemic-related stress was associated with decreased emotional functioning over time. Youth SR, particularly emotional and behavioral aspects, predicted better emotional and T1D-related functioning. Discussion While youth with T1D whose families experienced higher pandemic-related stress had poorer adjustment, strong emotional and behavioral SR appeared to protect against worsening youth mood and adherence across pandemic onset. Both social-contextual and individual factors are important to consider when working with families managing T1D.

Anxiety, Distress and Stress among Patients with Diabetes during COVID-19 Pandemic: A Systematic Review and Meta-Analysis

“…The average anxiety levels varied from minimal [37,44,47,50,56,58,61], to mild [26,36,52], to moderate [62], to severe [39]. For diabetes distress, the mean levels were low [31,45,47,55,58], moderate [33,52,60], and high [29,54].…”

“…For diabetes distress, the mean levels were low [31,45,47,55,58], moderate [33,52,60], and high [29,54]. The mean stress levels found ranged from minimal [50,56,57,59], moderate [35,39,40,43,49,52,62], and high [46].…”