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Open Access 01-12-2024 | Type 2 Diabetes | Research

COVID-19 pandemic-related healthcare interruptions and diabetes distress: a national study of US adults with diabetes

Authors: Ankeeta Saseetharran, Shivani A. Patel

Published in: BMC Public Health | Issue 1/2024

Abstract

Background

Early COVID-19 pandemic research found changes in health care and diabetes management, as well as increased diabetes distress. This study aims to determine the association between COVID-19 pandemic-related healthcare interruptions and diabetes distress among adults with Type 1 and Type 2 diabetes in the US in 2021.

Methods

Multinomial logistic regression was used to analyze moderate and high levels of diabetes distress (reference = no diabetes distress) in 228 individuals with Type 1 diabetes and 2534 individuals with Type 2 diabetes interviewed in the National Health Interview Survey in 2021.

Results

Among adults with Type 1 diabetes, 41.2% experienced moderate diabetes distress and 19.1% experienced high diabetes distress, and among adults with Type 2 diabetes, 40.8% experienced moderate diabetes distress and 10.0% experienced high diabetes distress. In adults with Type 1 diabetes, experiencing delayed medical care was associated with an adjusted odds ratio (aOR) of 4.31 (95% CI: 1.91–9.72) for moderate diabetes distress and 3.69 (95% CI: 1.20–11.30) for high diabetes distress. In adults with Type 2 diabetes, experiencing delayed medical care was associated with an aOR of 1.61 (95% CI: 1.25–2.07) for moderate diabetes distress and 2.27 (95% CI: 1.48–3.49) for high diabetes distress. Similar associations were observed between not receiving medical care due to the pandemic and diabetes distress. Conclusion: Among people with diabetes, experiencing delayed medical care and not receiving care due to the pandemic were associated with higher reports of diabetes distress.

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Devarajooh C, Chinna K. Depression, distress and self-efficacy: the impact on diabetes self-care practices. PLoS ONE. 2017;12:e0175096. https://doi.org/10.1371/journal.pone.0175096.CrossRefPubMedPubMedCentral

Gonzalez JS, Shreck E, Psaros C, Safren SA. Distress and type 2 diabetes-treatment adherence: a mediating role for perceived control. Health Psychol. 2015;34:505–13. https://doi.org/10.1037/hea0000131.CrossRefPubMed

van Bastelaar KMP, Pouwer F, Geelhoed-Duijvestijn PHLM, Tack CJ, Bazelmans E, Beekman AT, et al. Diabetes-specific emotional distress mediates the association between depressive symptoms and glycaemic control in type 1 and type 2 diabetes. Diabet Med. 2010;27:798–803. https://doi.org/10.1111/j.1464-5491.2010.03025.x.CrossRefPubMed

Fisher L, Mullan JT, Arean P, Glasgow RE, Hessler D, Masharani U. Diabetes distress but not clinical depression or depressive symptoms is associated with glycemic control in both cross-sectional and longitudinal analyses. Diabetes Care. 2010;33:23–8. https://doi.org/10.2337/dc09-1238.CrossRefPubMed

Tsujii S, Hayashino Y, Ishii H, Diabetes Distress and Care Registry at Tenri Study Group. Diabetes distress, but not depressive symptoms, is associated with glycaemic control among Japanese patients with type 2 diabetes: diabetes distress and Care Registry at Tenri (DDCRT 1). Diabet Med. 2012;29:1451–5. https://doi.org/10.1111/j.1464-5491.2012.03647.x.CrossRefPubMed

Hessler DM, Fisher L, Polonsky WH, Masharani U, Strycker LA, Peters AL, et al. Diabetes distress is linked with worsening diabetes management over time in adults with type 1 diabetes. Diabet Med. 2017;34:1228–34. https://doi.org/10.1111/dme.13381.CrossRefPubMedPubMedCentral

Balakumar P, Maung-U K, Jagadeesh G. Prevalence and prevention of cardiovascular disease and diabetes mellitus. Pharmacol Res. 2016;113:600–9.CrossRefPubMed

Rubin RR, Peyrot M, Siminerio LM. Health care and patient-reported outcomes: results of the cross-national diabetes attitudes, wishes and needs (DAWN) study. Diabetes Care. 2006;29:1249–55. https://doi.org/10.2337/dc05-2494.CrossRefPubMed

Walker RJ, Gebregziabher M, Martin-Harris B, Egede LE. Relationship between social determinants of health and processes and outcomes in adults with type 2 diabetes: validation of a conceptual framework. BMC Endocr Disord. 2014;14:82. https://doi.org/10.1186/1472-6823-14-82.CrossRefPubMedPubMedCentral

10.

Chen P, Callisaya M, Wills K, Greenaway T, Winzenberg T. Cognition, educational attainment and diabetes distress predict poor health literacy in diabetes: a cross-sectional analysis of the SHELLED study. PLoS ONE. 2022;17:e0267265. https://doi.org/10.1371/journal.pone.0267265.CrossRefPubMedPubMedCentral

11.

Polonsky WH, Fisher L, Guzman S, Sieber WJ, Philis-Tsimikas A, Edelman SV. Are patients’ initial experiences at the diagnosis of type 2 diabetes associated with attitudes and self-management over time? Diabetes Educ. 2010;36:828–34. https://doi.org/10.1177/0145721710378539.CrossRefPubMed

12.

Wardian J, Sun F. Factors associated with diabetes-related distress: implications for diabetes self-management. Soc Work Health Care. 2014;53:364–81. https://doi.org/10.1080/00981389.2014.884038.CrossRefPubMedPubMedCentral

13.

Czeisler MÉ, Barrett CE, Siegel KR, Weaver MD, Czeisler CA, Rajaratnam SMW, et al. Health Care Access and use among adults with diabetes during the COVID-19 pandemic — United States, February–March 2021. MMWR Morb Mortal Wkly Rep. 2021;70:1597–602. https://doi.org/10.15585/mmwr.mm7046a2.CrossRefPubMedPubMedCentral

14.

Fisher L, Polonsky W, Asuni A, Jolly Y, Hessler D. The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: a national cohort study. J Diabetes Complications. 2020;34:107748. https://doi.org/10.1016/j.jdiacomp.2020.107748.CrossRefPubMedPubMedCentral

15.

NHIS - About the National Health Interview Survey. National Center for Health Statistics. 2022. https://www.cdc.gov/nchs/nhis/about_nhis.htm (accessed February 1, 2023).

16.

Gaffney A, Himmelstein DU, Woolhandler S. Prevalence and correlates of patient rationing of insulin in the United States: A National Survey. Ann Intern Med. 2022;175(11):1623–6.

17.

Baek RN, Tanenbaum ML, Gonzalez JS. Diabetes burden and diabetes distress: the buffering effect of social support. Ann Behav Med. 2014;48:145–55. https://doi.org/10.1007/s12160-013-9585-4.CrossRefPubMed

18.

Yang Q-Q, Sun J-W, Shao D, Zhang H-H, Bai C-F, Cao F-L. The Association between Diabetes complications, Diabetes Distress, and depressive symptoms in patients with type 2 diabetes Mellitus. Clin Nurs Res. 2021;30:293–301. https://doi.org/10.1177/1054773820951933.CrossRefPubMed

19.

Fisher L, Polonsky WH, Hessler DM, Masharani U, Blumer I, Peters AL, et al. Understanding the sources of diabetes distress in adults with type 1 diabetes. J Diabetes Complications. 2015;29:572–7. https://doi.org/10.1016/j.jdiacomp.2015.01.012.CrossRefPubMedPubMedCentral

20.

McCarthy MM, Whittemore R, Gholson G, Grey M, Diabetes, Distress. Depressive symptoms, and Cardiovascular Health in adults with type 1 diabetes. Nurs Res. 2019;68:445–52. https://doi.org/10.1097/NNR.0000000000000387.CrossRefPubMedPubMedCentral

21.

Stahl-Pehe A, Glaubitz L, Bächle C, Lange K, Castillo K, Tönnies T, et al. Diabetes distress in young adults with early-onset type 1 diabetes and its prospective relationship with HbA1c and health status. Diabet Med. 2019;36:836–46. https://doi.org/10.1111/dme.13931.CrossRefPubMed

22.

Pate R, Caswell N, Gardner KJ, Holyoak L. A structural equation model in adults with type 1 and 2 diabetes: exploring the interplay of psychological states and diabetes outcomes, and the mediating effect of resilience. Acta Diabetol. 2022;59:1575–87. https://doi.org/10.1007/s00592-022-01955-3.CrossRefPubMedPubMedCentral

23.

Kintzoglanakis K, Gkousiou A, Vonta P, Sagmatopoulos A, Copanitsanou P. Depression, anxiety, and diabetes-related distress in type 2 diabetes in primary care in Greece: different roles for glycemic control and self-care. SAGE Open Med. 2022;10:20503121221096604. https://doi.org/10.1177/20503121221096605.CrossRef

24.

Delahanty LM, Grant RW, Wittenberg E, Bosch JL, Wexler DJ, Cagliero E, et al. Association of diabetes-related emotional distress with diabetes treatment in primary care patients with type 2 diabetes - PubMed. Diabet Med. 2007;24:48–54. https://doi.org/10.1111/j.1464-5491.2007.02028.x.CrossRefPubMed

25.

Powers MA, Richter SA, Ackard DM, Craft C. Diabetes distress among persons with type 1 diabetes. Diabetes Educ. 2017;43:105–13. https://doi.org/10.1177/0145721716680888.CrossRefPubMed

26.

Vallis M, Willaing I, Holt RIG. Emerging adulthood and type 1 diabetes: insights from the DAWN2 study. Diabet Med. 2018;35:203–13. https://doi.org/10.1111/dme.13554.CrossRefPubMed

27.

Pandit AU, Bailey SC, Curtis LM, Seligman HK, Davis TC, Parker RM, et al. Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes. J Epidemiol Community Health. 2014;68:557–64. https://doi.org/10.1136/jech-2013-203063.CrossRefPubMed

28.

Harris MI. Racial and ethnic differences in health care access and health outcomes for adults with type 2 diabetes. Diabetes Care. 2001;24:454–9. https://doi.org/10.2337/diacare.24.3.454.CrossRefPubMed

29.

Kollannoor-Samuel G, Vega-López S, Chhabra J, Segura-Pérez S, Damio G, Pérez-Escamilla R. Food Insecurity and low self-efficacy are Associated with Health Care Access barriers among Puerto-ricans with type 2 diabetes. J Immigr Minor Health. 2012;14:552–62. https://doi.org/10.1007/s10903-011-9551-9.CrossRefPubMedPubMedCentral

30.

Thomas LV, Wedel KR, Christopher JE. Access to Transportation and Health Care visits for Medicaid enrollees with diabetes. J Rural Health. 2018;34:162–72. https://doi.org/10.1111/jrh.12239.CrossRefPubMed

31.

Levy NK, Park A, Solis D, Hu L, Langford AT, Wang B, et al. Social Determinants of Health and Diabetes-related distress in patients with insulin-dependent type 2 Diabetes: cross-sectional, mixed methods Approach. JMIR Form Res. 2022;6:e40164. https://doi.org/10.2196/40164.CrossRefPubMedPubMedCentral

32.

Hippisley-Cox J, Yates J, Pringle M, Coupland C, Hammersley V. Sex inequalities in access to care for patients with diabetes in primary care: questionnaire survey. Br J Gen Pract. 2006;56:342–8.PubMedPubMedCentral

33.

Kibbey KJ, Speight J, Wong JLA, Smith LA, Teede HJ. Diabetes care provision: barriers, enablers and service needs of young adults with type 1 diabetes from a region of social disadvantage. Diabet Med. 2013;30:878–84. https://doi.org/10.1111/dme.12227.CrossRefPubMed

34.

Mizokami-Stout K, Choi H, Richardson CR, Piatt G, Heisler M. Diabetes distress and Glycemic Control in Type 2 diabetes: Mediator and Moderator Analysis of a peer support intervention. JMIR Diabetes. 2021;6:e21400. https://doi.org/10.2196/21400.CrossRefPubMedPubMedCentral

35.

Hansen UM, Skinner T, Olesen K, Willaing I, Diabetes Distress. Intentional hyperglycemia at work, and Glycemic Control among Workers with type 1 diabetes. Diabetes Care. 2019;42:797–803. https://doi.org/10.2337/dc18-1426.CrossRefPubMed

36.

Cook A (Sasha), editor. Zill A. Working With Type 1 Diabetes: Investigating the Associations Between Diabetes-Related Distress, Burnout, and Job Satisfaction. Front Psychol 2021;12:697833. https://doi.org/10.3389/fpsyg.2021.697833.

37.

Fisher L, Skaff MM, Mullan JT, Arean P, Glasgow R, Masharani U. A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with type 2 diabetes. Diabet Med. 2008;25:1096–101. https://doi.org/10.1111/j.1464-5491.2008.02533.x.CrossRefPubMedPubMedCentral

38.

Fisher L, Hessler D, Polonsky W, Strycker L, Masharani U, Peters A. Diabetes distress in adults with type 1 diabetes: prevalence, incidence and change over time. J Diabetes Complications. 2016;30:1123–8. https://doi.org/10.1016/j.jdiacomp.2016.03.032.CrossRefPubMedPubMedCentral

39.

Beverly EA, Rennie RG, Guseman EH, Rodgers A, Healy AM. High prevalence of diabetes distress in a University Population. J Osteopath Med. 2019;119:556–68. https://doi.org/10.7556/jaoa.2019.099.CrossRef

40.

Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, et al. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2005;28(3):626–31.CrossRefPubMed

Title: COVID-19 pandemic-related healthcare interruptions and diabetes distress: a national study of US adults with diabetes
Authors: Ankeeta Saseetharran
Shivani A. Patel
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Type 2 Diabetes
Type 1 Diabetes
COVID-19
Published in: BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-024-17921-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

COVID-19 pandemic-related healthcare interruptions and diabetes distress: a national study of US adults with diabetes

Abstract

Background

Methods

Results

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

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