Impact of the COVID-19 pandemic and lockdown restrictions on psychosocial and behavioural outcomes among Australian adults with type 2 diabetes: findings from the PREDICT cohort study

Diabet Med. 2021 May 30:e14611. doi: 10.1111/dme.14611. Online ahead of print.

ABSTRACT

AIM: To examine psychosocial and behavioural impacts of the COVID-19 pandemic and lockdown restrictions among adults with type 2 diabetes.

METHODS: Participants enrolled in the Progression of Diabetic Complications (PREDICT) cohort study in Melbourne, Australia (n=489 with a baseline assessment pre-2020) were invited to complete a phone/online follow-up assessment in mid-2020 (i.e. amidst COVID-19 lockdown restrictions). Repeated assessments that were compared with pre-COVID-19 baseline levels included anxiety symptoms (GAD-7), depressive symptoms (PHQ-8), diabetes distress (PAID), physical activity/sedentary behaviour, alcohol consumption, and diabetes self-management behaviours. Additional once-off measures at follow-up included COVID-19-specific worry, quality of life (QoL), and healthcare appointment changes (telehealth engagement and appointment cancellations/avoidance).

RESULTS: Among 470 respondents (96%; aged 66±9 years, 69% men), at least 'moderate' worry about COVID-19 infection was reported by 31%, and 29-73% reported negative impacts on QoL dimensions (greatest for: leisure activities, feelings about the future, emotional wellbeing). Younger participants reported more negative impacts (P<0.05). Overall, anxiety/depressive symptoms were similar at follow-up compared with pre-COVID-19, but diabetes distress reduced (P<0.001). Worse trajectories of anxiety/depressive symptoms were observed among those who reported COVID-19-specific worry, or negative QoL impacts (P<0.05). Physical activity trended lower (~10%), but sitting time, alcohol consumption and glucose-monitoring frequency remained unchanged. 73% of participants used telehealth, but 43% cancelled a healthcare appointment and 39% avoided new appointments despite perceived need.

CONCLUSIONS: COVID-19 lockdown restrictions negatively impacted QoL, some behavioural risk factors, and healthcare utilisation in adults with type 2 diabetes. However, generalised anxiety and depressive symptoms remained relatively stable.

PMID:34053106 | DOI:10.1111/dme.14611