Provider contact, COVID-19 risk among concerns for adults with diabetes during pandemic
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Adults with type 2 diabetes described difficulties with contacting health care providers and receiving information about links between diabetes and COVID-19 during the pandemic, according to findings from a qualitative study.
In a study published in Diabetic Medicine, researchers interviewed adults with type 2 diabetes from the U.K. about their experiences living with type 2 diabetes during the COVID-19 pandemic. In addition to expressing concerns about receiving relevant health information, participants described worries about contracting the disease itself, changes with their physical activity and diabetes self-management routine, and concerns with social isolation during lockdowns.
“This qualitative study aimed to describe the experiences of diabetes self-care during the COVID-19 pandemic, in a purposively diverse group of people with type 2 diabetes from South London,” Rebecca Upsher, PhD, a teaching fellow in the department of psychology at King’s College London, and colleagues wrote. “Three major themes were outlined: information needs of people with type 2 diabetes during the COVID-19 pandemic; concerns about COVID-19 from people with type 2 diabetes; and diabetes self-management and well-being during the COVID-19 pandemic.”
Researchers recruited 29 adults who previously participated in the South London Diabetes prospective study. Participants had been newly diagnosed with type 2 diabetes within 6 months of recruitment to the South London Diabetes study between 2009 and 2012. Those who completed a follow-up between 2017 and 2020 were eligible to participate. Adults were interviewed between Sept. 8, 2020, and Jan. 25, 2021. Interviewers developed a topic guide based on a guide developed during the H1N1 “swine flu” pandemic in 2010, with revisions made to add diabetes- and COVID-19-specific questions. Interviews were conducted by telephone and were audio recorded. Deductive thematic analysis was used to match themes to sections in the topic guide.
Of the study cohort, 79% were older than 65 years, and more than 70% did not have depressive symptoms at baseline of the South London Diabetes prospective study or at follow-up.
When discussing information needs, some participants had no problems contacting their health care providers during the pandemic, whereas others found contacting providers extremely difficult. Participants stated concerns about digital advances in health care during the pandemic and health care professional providing limited information on the link between diabetes and COVID-19.
Participants gave a variety of answers regarding concerns about COVID-19. Some adults said they felt that diabetes was not a risk factor or that maintaining good diabetes management would negate diabetes as a risk factor for adverse COVID-19 outcomes. Those who watched the news, however, said their mental health was negatively affected by reports stating diabetes increased the risk for severe outcomes. Some adults said they had concerns with other people’s lack of fear surrounding COVID-19, including people not following protective measures in public places or engaging in risk-taking behavior.
During the pandemic, many participants said they engaged in more sedentary lifestyles with minimal social activities. Most stated they decreased their level of physical activity and gained weight during lockdowns, whereas some increased physical activity levels by discovering new ways to exercise. Social isolation was a big concern for most participants, with several reporting isolation affected their mental well-being as time went on.
The researchers said the findings reveal several areas in which providers can improve their communication for people with type 2 diabetes during future pandemics. They said providers need to offer a consistent, clear message with diabetes-specific advice to promote preventive measures during a virus. Providers should also encourage health-promoting behaviors and try to mitigate concerns patients might have.
“Better support for people with type 2 diabetes who have poor digital literacy or lack access to digital resources is essential,” the researchers wrote. “Finally, there is a need for further development of resources to alleviate experiences of social isolation in people with type 2 diabetes who are already at increased risk of poor mental health.”
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