Cross-national comparison of psychosocial well-being and diabetes outcomes in adults with type 1 diabetes during the COVID-19 pandemic in US, Brazil, and Iran

Diabetology & Metabolic Syndrome

Katherine Miller-Bains¹  Edimariz Buin Cardoso²  Samereh Abdoli³  Leila Rafiee Vardanjani⁴  Danielle Hessler⁴  Elizabeth João Pavin⁵  Monica S. V. M. Silveira⁶  Paulo Fanti⁶  Mehri Doosti-Irani⁷  Kobra Noorjan⁷ 

[1] Assessment and Evaluation, Oak Ridge Associated Universities, 37831, Oak Ridge, TN, USA;Clinical Psychologist, Faculty of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, 13083-887, São Paulo, Brazil;College of Nursing, University of Tennessee, 1200 Volunteer Blvd Rm 155, 37996, Knoxville, TN, USA;Department of Family and Community Medicine, University of California, 500 Parnassus Avenue, 94117, San Francisco, CA, USA;Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, 13083-887, São Paulo, Brazil;Faculty of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, 13083-887, São Paulo, Brazil;School of Nursing and Midwifery, Shahrekourd University of Medical Sciences, Shahrekord, Iran;

关键词: COVID-19;    Burnout;    Distress;    Depression;    Diabetes;   

DOI  :  10.1186/s13098-021-00681-0

来源: Springer

【 摘 要 】

BackgroundThe COVID-19 pandemic is a global public health emergency, which presents wide-ranging negative impacts on individuals with diabetes. To examine psychosocial well-being and diabetes outcomes in individuals with type 1 diabetes during the COVID-19 pandemic, and investigate how these factors vary in different countries.MethodsBetween April and June 2020 we employed a cross national comparative research study in the United States (US), Brazil, and Iran to collect data from 1788 adults with type 1 diabetes using web-based survey. Study participants answered questions relevant to diabetes distress, diabetes burnout, depressive symptoms, COVID-19 related changes, and socio-demographic characteristics. They also reported their last Hemoglobin A1c (HbA1c) and daily Time-in-Range (TiR) blood glucose. We analyzed data using comparative tests (Chi-square, Kruskal–Wallis and McNemar test), logistic and linear regression adjusted for fixed effects.ResultsThere were significant changes prior and during the pandemic regarding access to diabetes care, diabetes supplies and medications, healthy food and safe places to exercise in all countries (p < 0.05). Participants in Iran experienced higher levels of diabetes distress (57.1%), diabetes burnout (50%), and depressive symptoms (60.9%), followed by Brazil and US (p < 0.0001). US participants reported better glycemic control (HbA1c = 6.97%, T1R = 69.64%) compared to Brazil (HbA1c = 7.94%, T1R = 51.95%) and Iran (HbA1c = 7.47%, T1R = 51.53%) (p < 0.0001). There were also significant relationships between psychosocial well-being, diabetes outcomes, socio-demographic data, and COVID-19 related challenges in overall sample (p < 0.05).ConclusionsRegardless of differences among US, Brazil, and Iran, our findings revealed that different countries may experience similar challenges related to the COVID-19 pandemic which can impact negatively diabetes outcomes and psychosocial well-being in individuals with type 1 diabetes. Countries need to consider modifiable variables associated with poor diabetes outcomes and sub optimal psychosocial well-being and target vulnerable population using significant socio-demographic variables.

【 授权许可】

CC BY