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
Open Access
- 11 June 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Diabetology & Metabolic Syndrome
- Vol. 13 (1), 1-12
- https://doi.org/10.1186/s13098-021-00681-0
Abstract
Background: The 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. Methods: Between 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. Results: There 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). Conclusions: Regardless 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.Keywords
Funding Information
- Shahrekord University of Medical Sciences
This publication has 52 references indexed in Scilit:
- Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran: Evidence from Micro-Simulation Markov Model and Bayesian Meta-AnalysisPLOS ONE, 2015
- Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health SurveysEpidemiology and Psychiatric Sciences, 2015
- The cost of type 1 diabetes: a nationwide multicentre study in BrazilBulletin of the World Health Organization, 2013
- Mental Health Issues in Adolescents and Young Adults With Type 1 DiabetesClinical Pediatrics, 2012
- When Is Diabetes Distress Clinically Meaningful?Diabetes Care, 2012
- Using mobile phones to measure adolescent diabetes adherence.Health Psychology, 2012
- Impact of a Natural Disaster on DiabetesDiabetes Care, 2009
- The PHQ-8 as a measure of current depression in the general populationJournal of Affective Disorders, 2009
- Improving the Quality of Web Surveys: The Checklist for Reporting Results of Internet E-Surveys (CHERRIES)Journal of Medical Internet Research, 2004
- Designs and Methods of Comparative Political Communication ResearchPublished by Cambridge University Press (CUP) ,2004