29 Jun ADA21: Disparate Impact of COVID-19 on People with Diabetes

MedicalResearch.com Interview with:

Dr. Mary de Groot

Mary de Groot, Ph.D.
Associate Professor
Immediate Past President, Health Care and Education, American Diabetes Association
Acting Director, Diabetes Translational Research Center
Indianapolis, IN 46202 

MedicalResearch.com: What is the background for this study?

Response: The experience of quarantine in the context of epidemics has been shown to have significant emotional effects including depression, anxiety, shock, and trauma that not only effect people in the context of quarantine, but up to 2-3 years beyond the end of the quarantine period (Brooks et al., 2020).  The COVID-19 pandemic has had extraordinary impacts on health and mental health in the general population across the globe including increased rates of depression and anxiety compared to pre-pandemic levels (Xiong, 2020; Wilson, 2020; Luo, 2020).

There is some early evidence that the pandemic adversely affected people with diabetes as well (Fisher, 2020; Alessi, 2020). It is important to explore the emotional impact of the COVID-19 pandemic for people with diabetes given the particular risk factor that diabetes (along with other metabolic diseases) represents for mortality if the virus is acquired.

We conducted a longitudinal web-based survey of N=2210 adults with and without diabetes to assess the emotional correlates of COVID-19 in terms of depression, diabetes distress, perceived stress and anxiety.  We present the baseline (measured in May/June of 2020) and 6-month follow up (measured in November/December 2020) findings.

MedicalResearch.com: What are the main findings?

Response: Main findings:

At Baseline:

• People with type 2 diabetes had higher rates of depression and depressive symptoms than people without diabetes.
• Diabetes distress levels were moderate to high in people with type 1 and type 2 diabetes.
• People of color (AAPI/Multiracial/AI and African Americans) showed worse outcomes on DDS-17 than Whites; influenced by age and income levels.
• People of Asian, Pacific Islander/Multiracial/American Indian showed highest depression scores; African Americans showed lowest PHQ-8 scores after controlling for covariates.

At Month 6:

• Depressive symptoms and diabetes distress levels did not significantly change at 6 Months after controlling for baseline levels and economic and social factors.
• Diabetes distress for people with type 1 and type 2 diabetes remained at moderate levels of severity at baseline and 6 Months
• Younger age groups (18-34 y.o.) showed greater emotional and financial burden during the pandemic with significantly higher mean depression and diabetes distress scores that persisted at 6 Months

MedicalResearch.com: What should readers take away from your report?

• Youth and older adults were both adversely affected by the COVID-19 pandemic experience but in different ways
• There is evidence for on-going mental health concerns 9 months into the U.S. COVID-19 pandemic experience
• Asian/Multi-racial participants showed a greater burden of stress and distress
• Social isolation was seen as a valuable safety behavior for people with diabetes
• It is important to continue to track long-term effects of the pandemic experience in people with and without diabetes.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: It will be important to continue to track the impact of the COVID-19 pandemic experience for people with and without diabetes in order to better understand the impact of the pandemic and the long-standing consequences of depression, stress and diabetes distress.  Ultimately, we will need to consider widely available interventions for depression and diabetes distress for people who continue to suffer from the impact of these extraordinary events. 

Funding for this research was provided by the Indiana University Diabetes Translational Research Center.

Citation: ADA 21 abstract

Health Disparities in People with and without Diabetes during the COVID-19 Pandemic

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Last Updated on June 29, 2021 by Marie Benz MD FAAD